Healthcare Payment and Financing Analyst

Healthcare Payment and Financing Analyst

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. 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.

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:

• 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