Contracting Analytics Specialist, Full Time- Days

Job Description Join UChicago Medicine as a Contracting Analytics Specialist in the Finance department. This position is primarily a work‑from‑home opportunity with the requirement to come onsite as needed. You may be based outside of the greater Chicagoland area. The Contracting Analytics Specialist is responsible for building and modeling all third‑party payer contract reimbursement terms including but not limited to Managed Care Commercial payers, Government programs (Medicare, IL Medicaid), Medicare Advantage payers and Medicaid MCO payers in UCM’s contract management systems or internally developed models. This includes interpretation of these analytical models – those currently in place, those proposed by UCM in negotiations with external parties, and those sent to us by external parties for consideration – for all system entities in order to meet UCM long‑term financial goals. The Specialist will serve as a managed care subject‑matter expert for hospital, physician, and other ancillary contract rate and language terms. The Specialist will run analyses to understand historical trends and future performance of existing and proposed contracts for internal benchmarking and reporting, and will be called upon to run analyses related to changes in reimbursement for future decision‑making, such as opening new facilities, switching sites of care, or introducing new technology or services. The Specialist will also assist the VP of Payer Contracting & Strategy; Executive Director of Payer Contracting, Financial Analytics & Operations; or any of the Payer Contracting Managers in contract negotiations as requested and applicable. Job Functions Assists Analytics Manager with modeling and analyzing current, proposed, and final contract pricing terms for UCM hospitals, physicians, and ambulatory/ancillary providers to determine revenue and operating margin changes; includes fee‑for‑service financial terms for commercial and governmental payers, ACO models, shared savings/shared risk, capitation, bundled pricing, and percent of premium. Assists Analytics Manager with developing robust financial business analytics to determine operational impacts and reporting needs, especially regarding managed care business and the goal of revenue optimization. Utilizes contract management system to inform rate analyses and performs regular maintenance and auditing of contract management rate calculations to check for variances to expected contract terms. Continues education on ever‑changing reimbursement rules and policy updates for commercial and governmental payers, educates internal stakeholders on reimbursement terms, methodology and impacts as needed, and provides contract rate or language information to other teams across the organization in a formal or ad‑hoc setting. Aids in strategic pricing analysis to support payer rate parity and pricing transparency work, including periodic market comparisons and surveillance. Works collaboratively to provide committee, EVP, and Board presentation materials on topics related to contract financial terms in support of VP of Payer Contracting & Strategy and CFO. Maintains strong attention to detail and organization; communicates effectively both verbally and in writing. Interacts effectively with colleagues in a variety of contexts and forums and contributes as a team player. Requires advanced proficiency in Microsoft Office Suite, particularly Excel and PowerPoint; has strong aptitude for learning additional software or systems as needed, especially finance and revenue‑cycle applications. SQL database experience is highly desirable but not required. Tableau experience is highly desirable but not required. Current operations are supported with NThrive/FinThrive as the contract management and modeling tool; experience with this is highly desirable but not required. Familiarity with and aptitude for some form of contract management and/or cost accounting systems for data gathering and model analysis is highly desirable. Required Qualifications Requires a Bachelor’s degree, preferably in finance or a related field. Requires a minimum of three or more years of related health‑care experience in financial analysis and data modeling, with a record of successfully completing similar duties, demonstrating considerable knowledge of health‑care organizations, operations, finance, and managed care. Experience with multi‑facility health systems, large academic and community physician groups or clinically integrated networks, large academic medical centers or insurers is highly desirable. Has detailed knowledge and experience with hospital and physician complex reimbursement methodologies, including FFS and value‑based care (VBC) risk reimbursement structures such as Medicare and Medicaid. Excellent understanding of general healthcare contract language and rate terms; knows physician and hospital coding and billing, claims forms and payment methodologies, payer EOBs, and insurance laws. Demonstrates proficiency with MS‑DRG, APC, EAPG, case rate, stop‑loss, carve‑out reimbursement methodologies, Revenue Code and CPT coding in clinical/hospital/ASC/physician office settings, and manage‑care contract rate interpretation skills. Skills / Preferred Qualifications Requires the ability to develop insightful observations and recommendations for courses of action from the analysis of complex situations, and to communicate those concepts clearly and effectively in both spoken and written form. Works effectively independently and collaboratively with cross‑functional teams to meet goals and improve organizational performance. Exhibits excellent analytical and problem‑solving skills, with high mathematical acumen, ability to access and assimilate data, and articulate a strong case for a recommended course of action. Understands and interprets federal regulations and policies, coding guidelines and reimbursement changes. Maintains strong attention to detail and organization; communicates effectively both verbally and in writing; contributes as a team player. Shows strong aptitude for learning additional software or systems as needed, especially finance and revenue‑cycle applications. Experience with NThrive/FinThrive as the contract management and modeling tool is highly desirable but not required. Familiarity with and aptitude for some form of contract management and/or cost accounting system for data gathering and model analysis is highly desirable. SQL experience is strongly preferred. Remains present and focuses on addressing one patient at a time, giving full attention. Exercises patience and empathy at all times, putting oneself in others’ shoes. Position Details Job Type/FTE: (1.00) Full Time Shift/Location: Days (8am‑5pm) Flexible morning start time Unit: Finance CBA Code: Non‑Union Equal Employment Opportunity UChicago Medicine is an equal‑opportunity employer. We evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status and other legally protected characteristics. Compensation & Benefits Overview UChicago Medicine is committed to transparency in compensation and benefits. The pay range provided reflects the anticipated wage or salary reasonably expected to be offered for the position. The pay range is based on a full‑time equivalent (1.0 FTE) and is reflective of current market data, reviewed on an annual basis. Compensation offered at the time of hire will vary based on candidate qualifications and experience and organizational considerations, such as internal equity. Pay ranges for employees subject to Collective Bargaining Agreements are negotiated by the medical center and their respective union. Review the full complement of benefit options for eligible roles at Benefits – UChicago Medicine. As a condition of employment, all employees are required to complete a pre‑employment physical, background check, drug screening, and comply with the flu vaccination requirements prior to hire. Medical and religious exemptions will be considered for flu vaccination consistent with applicable law. #J-18808-Ljbffr UChicago Medicine