Manager, Strategic Pricing and Analytics – Health Plan Relations

🕒 il y a 1 mois

🎸 Tennessee – Distant

🎸 Tennessee – Remote

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

👔 Manager

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AMSURG

Site WebLinkedInTous les Emplois

1001 - 5000 employés

🤝 B2B

🏢 Entreprise

B2B • Enterprise

AMSURG est le leader nationalement reconnu dans la gestion stratégique et opérationnelle des centres de chirurgie ambulatoire (ASC), fournissant des services chirurgicaux de jour de haute qualité et à forte valeur ajoutée, ainsi qu'une expérience patient supérieure. L'entreprise s'associe à des groupes de médecins et à des systèmes de santé pour former des coentreprises et gère les opérations des ASC, y compris les services d'anesthésie et les centres spécialisés pour les procédures gastro-intestinales, d'ophtalmologie et orthopédiques. AMSURG met l'accent sur la qualité, la gestion par consensus avec les partenaires médecins et une expertise opérationnelle évolutive à travers les États-Unis.

Description

• Lead anesthesia reimbursement analytics including forecasting, payer trend analysis, variance identification, and strategic pricing recommendations across commercial, government, and out‑of‑network (OON) payment scenarios. • Deliver advanced OON and No Surprises Act (NSA) analytics, support the IDR process, and build dashboards and financial models that inform leadership and drive pricing and revenue optimization. • Support ASC chargemaster development and maintenance by performing detailed analyses, updating CPT mappings, setting fee parameters, and preparing recommended charge models based on contract terms, volume data, and payer requirements. • Coordinate approvals and compliance workflows by tracking centers, reviewing operating agreements and payer notification language, preparing analysis and proposed chargemasters, and managing approvals. • Prepare and distribute finalized chargemasters and documentation by creating distribution files, maintaining tracking logs, ensuring effective dates and notification timelines are met, and supporting payer notification and operational implementation. • Oversee the execution of ad hoc reimbursement analyses and other custom analytics requested by leadership to drive informed strategic decisions.

🎯 Exigences

• Bachelor’s degree required, preferably in Finance, Accounting, Healthcare Administration, or a related field. • 5–7 years of progressive experience in healthcare analytics, pricing, or reimbursement analysis. • Expertise in healthcare industry, managed care contracts, reimbursement methodologies, and pricing strategies. • Track record of strong critical thinking and problem-solving ability. • Fluency in Microsoft Office applications with advanced Excel skills required. • Basic, working knowledge of SQL required. • Ability to build and audit complex Excel-based financial models, analyze data, and translate analyses into specific, targeted actions to drive results. • Expertise in working with complex and large volumes of data. • Demonstrated ability to design, develop, and implement routine and custom reporting. • Demonstrated ability to effectively communicate with C-suite and executive leadership.

🏖️ Avantages

• Paid Time Off • Medical • Dental • Vision • Life • Disability • Healthcare FSA • Dependent Care FSA • Limited Healthcare FSA • FSAs for Transportation and Parking & HSAs • Matching 401(K) Plan • Paid family leave • 9 observed holidays