Senior Manager, Managed Care Analytics - Full Time - Days - Corporate

Job Description

The Senior Manager of Managed Care Analytics serves as the enterprise leader for payer analytics, reimbursement modeling, and data governance across the managed care contracting lifecycle. This role is the system's chief data steward for managed care, responsible for ensuring analytical accuracy, methodological consistency, and strategic insight that directly shapes payer negotiations, revenue integrity, and long-term financial performance. This leader oversees a team of analysts and collaborates closely with Managed Care, Finance, Revenue Cycle, Population Health, Clinical Operations, and executive leadership. The Director drives the development of advanced financial models, contract repricing engines, payer scorecards, and market intelligence tools that support both fee-for-service and value-based arrangements.

• Serve as the Managed Care department's data steward, ensuring data accuracy
• Partner with IT, Finance, Revenue Cycle, and Informatics to align data sources, methodologies, and reporting infrastructure.
• Lead financial modeling and repricing analyses to support payer contract negotiations across hospital, physician, ancillary, and value based arrangements.
• Analyze historical and projected payer performance, including medical cost trends, utilization patterns, yield changes, and reimbursement impacts.
• Forecast financial risks and opportunities associated with managed care contracts.
• Serve as the subject matter expert on reimbursement methodologies (DRG, per diem, percent of charge, fee schedule, etc.).
• Oversee the creation of dashboards that track fee for service and value based contract performance
• Build payer/program specific P&Ls and profitability analyses.
• Query, integrate, and normalize complex datasets (hospital, professional billing, pharmacy, claims, third party sources).
• Maintain market intelligence tools, including competitor profiling and regional market assessments.
• Validate data extracts, troubleshoot discrepancies, and ensure analytical accuracy.
• Use Epic tools to model contract changes, forecast reimbursement impacts, and support negotiation strategy.
• Collaborate with the Director of Managed Care to prioritize and assign analytical work, review outputs, and ensure adherence to data governance standards.
• Foster a collaborative, high-performance analytical environment.
• Act as a key analytical partner to Finance, Revenue Cycle, ACO/Population Health, Clinical Operations, and other stakeholders.
• Participate in interdisciplinary workgroups and system wide initiatives requiring payer analytics or reimbursement expertise.
• Clearly convey complex analytical insights to leadership and diverse stakeholder groups
• Serve as the system expert on DRG, APC, fee schedule, percent of charge, bundled payments, and emerging reimbursement methodologies.
• Lead payer proposal evaluation, counter proposal development, and negotiation analytics.
• Develop dashboards and scorecards that track payer performance, yield, denial trends, PMPM, MLR, TME, and value-based metrics.
• Build payer specific P&Ls and profitability analyses.
• Monitor medical cost trends, utilization patterns, and reimbursement shifts
• Drive automation of recurring analytics, including SQL pipelines, BI dashboards, and contract modeling workflows
  

Qualifications

* Bachelor's degree in Healthcare Administration, Business, Public Health, Mathematics, Informatics, Computer Science, or related field.
* Master's degree (MBA, MHA, MPH, Informatics) preferred.
Experience
* 5-8 years of experience in medical cost analytics, managed care analytics, actuarial analysis, or related healthcare data roles preferred
* Experience leading analytical projects or teams; project management experience preferred.
* Strong understanding of managed care reimbursement methodologies and medical economics metrics (PMPM, MLR, TME, etc.).
* Experience working with healthcare claims, encounter data, and financial modeling.
* Proficiency in SQL, Excel (advanced modeling, macros/VBA), and BI tools such as Power BI, Tableau, or Spotfire.
Certifications
* Epic Resolute Hospital Billing and/or Professional Billing Contract Administration preferred; required within 9 months if not already certified.

About Us

At Atlantic Health, our promise to our communities is; Anyone who enters one of our facilities will receive the highest quality care delivered at the right time, at the right place, and at the right cost. This commitment is also echoed in the respect, development and opportunities we give to our more than 22,000 team members. Headquarters in Morristown, New Jersey, we are one of the leading non-profit health care systems in the nation. Our facilities and sites of care include:

• Atlantic Health Morristown Medical Center, Morristown, NJ
• Atlantic Health Overlook Medical Center, Summit, NJ
• Atlantic Health Newton Medical Center, Newton, NJ
• Atlantic Health Chilton Medical Center, Pompton Plains, NJ
• Atlantic Health Hackettstown Medical Center, Hackettstown, NJ
• Atlantic Health Goryeb Children's Hospital, Morristown, NJ
• Atlantic Health CentraState Healthcare System, Freehold, NJ
• Atlantic Medical Group
• Atlantic Visiting Nurse
• Atlantic Mobile Health
• Atlantic Rehabilitation

We have more than 900 community-based healthcare providers affiliated through Atlantic Medical Group.

We have received awards and recognition for the services we have provided to our patients, team members and communities. Below are just a few of our accolades:

• Chosen for 17 years by Fortune as one of the magazine's "100 Best Companies to Work For."
• Atlantic Health Morristown and Atlantic Health Overlook Named by Newsweek as two of the "World's Best Hospitals" in 2026.
• Atlantic Health Morristown and Atlantic Health Overlook ranked within the top three hospitals in New Jersey by U.S. News & World Report's 2025-2026 Best Hospital rankings.
• Atlantic Health scored four "A" grades by The Leapfrog Group in its Fall 2025 Hospital Safety Grades, performance measures reflecting errors, accidents, injuries and injections, as well as systems hospitals have in place to prevent harm.
• Atlantic Health Morristown and Atlantic Health Overlook are New Jersey's only hospitals to be named among America's 50 Best hospitals by Healthgrades in 2026.
• Named by Becker's Healthcare as one of the "165 Top Places to Work in Healthcare - 2026.
• Atlantic Health Morristown, Atlantic Health Overlook, Atlantic Health Chilton and Atlantic Health Newton all Forbes Top Hospitals for 2026.
• Named by Newsweek as one of America's Greatest Workplaces for Inclusion & Diversity 2025.
• Atlantic Health rated LEVEL 9 - 2025 CHIME Digital Health Most Wired.

Atlantic Health offers a competitive and comprehensive Total Rewards package that supports the health, financial security, and well-being of all team members. Offerings vary based on role level (Team Member, Director, Executive). Below is a general summary, with role-specific enhancements highlighted:

Team Member Benefits

• Medical, Dental, Vision, Prescription Coverage (22.5 hours per week or above for full-time and part-time team members)
• Life & AD&D Insurance.
• Short-Term and Long-Term Disability (with options to supplement)
• 403(b) Retirement Plan: Employer match, additional non-elective contribution
• PTO & Paid Sick Leave
• Tuition Assistance, Advancement & Academic Advising
• Parental, Adoption, Surrogacy Leave
• Backup and On-Site Childcare
• Well-Being Rewards
• Employee Assistance Program (EAP)
• Fertility Benefits, Healthy Pregnancy Program
• Flexible Spending & Commuter Accounts
• Pet, Home & Auto, Identity Theft and Legal Insurance

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Note: In Compliance with the NJ Pay Transparency Act (effective Sunday, June 1, 2025), all job postings will include the hourly wage or salary (or a range), as well as this summary of benefits. Final compensation and benefit eligibility may vary by role and employment status and will be confirmed at the time of offer.

EEO STATEMENT

Atlantic Health, Inc. is an equal employment opportunity employer and federal contractor or subcontractor and therefore abides by applicable laws to protect applicants and employees from discrimination in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment, on the basis of race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, citizenship status, disability, age, genetics, or veteran

About the Team

Atlantic Health System is at the forefront of medicine, setting standards for quality health care powered by a workforce of more than 18,000 team members and 4,800 affiliated physicians dedicated to building healthier communities, the system offers more than 400 sites of care, including eight award-winning medical centers. Specializing in cardiovascular care, cancer care, orthopedics, neuroscience, pediatrics, women's health and rehabilitation medicine. Atlantic Medical Group, comprised of 1,000 physicians and advanced practice providers, represents one of the largest multi-specialty practices in New Jersey and includes finance, legal, marketing, human resources, talent acquisition, ISS and more. Caring for our patients, our team members and the communities we serve is our central mission.

Job Info

• Minimum Salary (Hourly Rate): 74.670000
• Maximum Salary (Hourly Rate): 131.440000
• Assignment Category: Full-time
• Hours per Week: 37.5
• Primary Shift: Day
• Salary Admin Plan: MGR