Healthcare Payment and Financing Analyst

Job Description

Job Description

Company Overview:

With an annual budget of $2.3 billion and more than 7,000 employees throughout the five boroughs, the New York City Department of Health and Mental Hygiene (NYC DOHMH) is one of the largest public health agencies in the world, serving 8 million New Yorkers from diverse ethnic and cultural backgrounds. We're tackling a broad range of public health issues with innovative policies and programs and getting exceptional results, but our work is never finished. The breadth of our innovative programs provides the widest range of choices for every member of our team.

DOHMH is undertaking a new initiative that will meet critical infrastructure needs and make possible strategic investments that will have lasting effects on public health, using grant funds from the Centers for Disease Control and Prevention (CDC). Investments and improvements through this initiative will help modernize DOHMH’s foundational capabilities and data infrastructure, enabling it to partner in complex health and health care environments and, in turn, support better public health outcomes, including COVID-19. This initiative supports larger efforts to rebalance investments in public health and more equitably serve communities and populations.

The selected candidate will be an employee of Public Health Solutions, a nonprofit organization which is the fiscal and administrative manager of the grant, but work will be supervised by DOHMH. This is a grant-funded position ending in November 2027.

Program Description:

The Center for Health Equity and Community Wellness (CHECW) aims to eliminate racial inequities resulting in premature mortality, with a focus on chronic disease, by addressing the social and environmental factors that impact health. CHECW works to increase placed-based investments in priority neighborhoods with community programming and services based on epidemiology; influence and leverage the health system to promote whole-person care; intensify the agency’s approach to tackling big salt, sugar, and tobacco; and finding innovative ways to improve the built environment and address other social determinants of health. CHECW is comprised of the Bureau of Bronx Neighborhood Health, the Bureau of Brooklyn Neighborhood Health, the Bureau of Harlem Neighborhood Health, the Bureau of Chronic Disease Prevention, the Bureau of Health Equity Capacity Building, the Bureau of Equitable Health Systems and the Bureau of Finance, Administration, and Services. CHECW seeks to create healthier neighborhoods by providing New Yorkers the information and resources they need to live healthy lives and work to remove health inequities between New York City neighborhoods that are the result of structural racism such as segregation and disinvestment and social capital.

Public health emergencies are becoming more frequent and severe. And public expectations for emergency response have changed in terms of speed of response, level of communications, among other things. As such, DOHMH must become a more “response-ready” Agency to enable more effective and efficient emergency operations. This means strengthening the Agency’s overall systems, processes, and policies to ensure a strong emergency infrastructure to support priority CHECW preparedness needs identified from the COVID-19 pandemic response and other previous emergencies. Emergency Preparedness and Response is a public health infrastructure foundational service, and DOHMH must build capability and capacity in this area to protect the public’s health.

Position Summary:

In this context, BEHS is looking to recruit an analyst to perform a variety of policy analyses of the financial incentives and payment innovations necessary to improve equity in healthcare access, outcomes, and healthcare accountability. General areas of work include but are not limited to:

• Provider payment and financing strategies for addressing health inequities and achieving health equity
• Implementation of New York State 1115 Medicaid waiver, state plan amendments (SPA) and additional initiatives with an equity focus and promoting place-based interventions
• Development and implementation of a Maternal Home Collaborative, a payment model to address maternal mortality and morbidity; with the potential opportunity to be co-located with CBO partner(s) and NYC Health Department
• Support for community and social services organizations to expand into a social care delivery system for Medicaid and other payors in a way that is easy-to-access for patients and providers, and financially sustainable.
• Facilitate inclusion of healthcare, preventive, and social care services into alternative payment models ; value-based payment (VBP), capitated arrangements, as examples; inclusive of through blending and braiding approaches.
• Policy, financing, and research analyses inclusive but not limited to: literature reviews, landscape analyses, reports, legislation, briefings, memos, publications, etc.

Specifically, the Healthcare Payment and Financing Analyst will:

Healthcare Payment and Financing :

• Investigate various healthcare payment and financing topics including but not limited to Medicaid/Medicare payment and credentialing, alternative payment models, and disproportionate share payments, etc.
• Perform policy and financing analyses and literature reviews of the impact of payment and financial policy changes and innovation nationally in quality and population health outcomes.
• Creates payment and finance policy goals. This includes but is not limited to preparing projected analyses on claims and utilization, including underlying trends and risk analyses to assist in planning for partner-led population health interventions.

Policy Planning, Development, Implementation, & Analyses:

• Lead policy analyses of healthcare payment and financing initiatives, policies, and legislation
• Prepare briefs, reports, and presentations
• Leads program development and implementation for healthcare payment and financing initiatives
• Leads, facilitates, and coordinates meetings with stakeholders including but not limited to scheduling, preparing presentations, taking notes, and providing follow-up to action items.
• Participates as Office of Healthcare System Strategy and Accountability (OHSSA) representative in workgroup(s)

Maternal Home Collaborative

• Support implementation of the Maternal Home Collaborative, a novel model to address maternal mortality and morbidity
• Opportunity to be co-located (CBOs and NYC Health Department) for direct service delivery, support services, reporting, and evaluation

Whole-person care:

• Collaborate with stakeholders to identify key segments of the population, providers, services etc. to target for high value interventions.
• Support the creation of a unified and operationally feasible vision for delivery of health-related-social-needs services so it maximizes impact on population health outcomes.
• Work with payers, providers, and community-based organizations to co-create win-win payment models for health equity innovations; including blended and braided funding.

Training

• Develop payment and financial analysis skills among policy and data analysts

Other

• Provide analysis of the unintended financial implications of policy and programs of interest for the health department.
• Investigate innovations in healthcare delivery and financing nationally and assess appropriateness and feasibility of implementation in New York.
• Additional duties, as assigned

Qualifications:

• Advanced degree (masters, MD, PhD, DrPH, JD) in business, public health, health policy & management, healthcare finance, economics, or similar
• 3+ years of experience in roles that provide in-depth understanding of financial incentives in the healthcare delivery and payment systems
• 3-5 years’ experience in progressively complex healthcare policy analyses
• 3+ years of experience analyzing Medicaid and/or Medicare Federal/State regulation.
• Experience doing research or analysis of healthcare policy
• Experience in policy and program planning, development, and implementation
• Experience producing briefs, memos, and reports
• Rapidly able to self-teach software products
• Highly analytical and detailed oriented
• Understanding of health care performance metrics and key operating indicators
• Knowledge of statistical and financial metrics in a health care environment such as payor mix
• Health Insurance experience and proficiency in understanding professional and facility claims and managed care concepts such as risk adjustment, capitation, FFS, DRG, APG, APCs and other payment mechanisms
• Some experience in social service or community-based organizations, preferably related to contracting with government and/or insurance companies.
• Effective communication and ability to translate financial information to non-financial customers (internal and external)
• Strong ability to handle multiple projects including problem solving, research, analysis, and communication in a fast-paced environment

Additional Desired Qualities

• Demonstrated knowledge in emerging ways to utilize electronic data for collaborative delivery and payment models (e.g. RHIOs)
• Advanced use of Microsoft Excel
• Experience in Management Service Organizations, Independent Practice Associations, or other shared service organizations.

Benefits:

• Hybrid Work Schedule.
• Generous Paid Time Off and Holidays.
• An attractive and comprehensive benefits package including Medical, Dental and Vision.
• Flexible Spending Accounts and Commuter Benefits.
• Company Paid Life Insurance and Disability Coverage.
• 403 (b) + employer matching and discretionary company contributions.
• College Savings Plan.
• Ongoing training and continuous opportunities for professional growth and development.

Additional Information :

• This is a temporary grant-funded position ending in November 2027.
• This individual must reside in the tri-state area (NY, NJ, CT) by their confirmed start date.
• Preference may be given to individuals residing in New York City (5 boroughs) or surrounding New York State counties.
• This individual will be expected to work non-business hours during emergencies.

At PHS, we place immense value on diversity within our teams, understanding that varied backgrounds and experiences significantly enhance our community and propel us toward our goals. If you find you don’t have experience in all the areas listed above, we still encourage you to apply and share your background and experiences in your application. We are eager to discover how your unique perspective can bring positive transformations to our team and help advance our mission of creating healthier, more equitable communities.

We look forward to learning more about you!

PHS is proud to be an equal opportunity employer and encourages applications from women, people of color, persons with disabilities, LGBTQIA+ individuals, and veterans.

Monday-Friday
Candidate can work in a hybrid capacity (remote/in-person).
35 Hours Per Week