Director, Managed Care Analytics

POSITION SUMMARY / RESPONSIBILITIES

The Director, Managed Care Analytics is responsible for the creation and development of detailed financial models, analyses and reports to support third party payer contract negotiations and optimization of the performance of existing third party payer relationships. Responsible for the development of the necessary reports to identify and assess contract performance trends and operational issues. Responsible for negotiating letters of agreement with non-contracted third party payers and ensuring that all parties to the contract fully understand financial and operational issues relating to letters of agreement. Responsible for educating staff in various departments on new or amended third party payer contract rates, terms, and conditions. Responsible for the development of a program of cross-training and maintenance of skills in the use of contract modeling information systems. Supports the Executive Director in the identification of potential business opportunities, contract negotiations, payer relationship development, and provider relationship development.

EDUCATION / EXPERIENCE

Bachelor’s degree in mathematics, statistics, business, or healthcare administration is required. A combined minimum of five (5) years’ experience in statistical and financial analyses, report writing, decision support, and / or third party payer contracting is preferred. Must have knowledge of Texas Medicaid system (traditional and managed care), as well as federal Medicare Advantage and commercial health insurance exchange programs. Must possess strong interpersonal skills as well as strong leadership qualities. Knowledge of Lean principles and experience implementing Lean practices is preferred. Progressively responsible management-level experience in an academic healthcare center preferred.

LICENSURE / CREDENTIALING

Managed Care certification by Healthcare Financial Management Association is preferred.