Regional Cost Analyst-Healthcare

Central connecticut, Connecticut | Direct Hire

Post Date: 06/01/2018 Job ID: 5600 Industry: Healthcare Informatics & Technology Salary / Pay Rate : 120K

Regional Cost Analyst-Healthcare

Provide RVU Based cost analysis within the  decision support division that oversees regional data supporting hospitals data, physician group data, laboratory data and payer contracts.

Focus on patient data, claims, quality outcomes, and general ledger data.

Allocates GDM Cost Accounting analytic support  with  Financial Analyst within a Healthcare Payer Strategy department.  

Manages several large  projects utilizing data analytics for  identifying cost drivers, implement and track cost reduction opportunities, utilize flexible and encounter-based budgeting,  negotiate payer contracts and for ACO model.

Works closely with the  Charge  Description Master CDM  to  review  the activity drivers and  the " primary" basis for allocating costs.

Review actual direct costs, time-based values, industry RVUs and non-chargeable activities that determine  the cost of a service.

Correlates the cost of care with quality outcomes to effectively balance the delivery of quality  care at a reasonable cost to the patient.

  Ensures accuracy and compliance with  relations with Medicare, Medicaid and Commercial health insurance plans and data. Examples of such issues include:

• Physician and hospital reimbursement and their financial performance

• Payment reform and  new payment models like bundled payments

• Management of medical cost trend, cost accounting

• Quality performance, incentives and measurement

• Price transparency

• Accountable care organization progress 

• Development and implementation of hospital and physician fee schedules

• State cost hearing reports, health plan membership and financial performance.


Qualifications:

• Bachelor' s degree is preferred  in business, health care administration, finance or related fields.

• Minimum of four years Financial Healthcare analytic and database experience required, MUST be  in a healthcare environment.

• Working knowledge and understanding of hospital/physician reimbursement methodologies and/or health insurance underwriting for assessing risk terms and analytic, CPT Codes, Medical Reimbursement and CPT Codes.

• Solid Financial Analytical competency in use of relational databases, such as ETL tools, SQL queries, or similar analytic tools: Tableau, Crystal, Access, McKesson or Kreg

• Solid understanding of the healthcare industry as context for analytic responsibilities; includes facts, concepts and trends that are general to the industry 

• Excellent quantitative and analytic skills, with the ability to understand complex concepts .

Requires the use of sophisticated software functionality including manipulation of large data sets, database management, experience with querying language and financial modeling.

• Strong communication skills, with the ability to break down and explain complex analytic issues along with presenting findings

. • Excellent customer service skills; demonstrates an understanding of customers' needs, provides accurate and reliable information  and maintains professional relationships with key contacts.

• Develop  ability to think strategically; able to develop well-reasoned conclusions, test against relevant criteria  and assess in context of the environment and organizational priorities.

Organized with  project managements skills; able to manage multiple projects and deadlines.

Effectively use various tools to initiate a project, monitor progress, anticipate obstacles and provide concise updates in a timely manner.t.

Proactive in identifying issues, prepared to address questions, makes recommendations.


Job type: Full time

Location: Central CT.

  110-120K

(salary may be negotiable)

Send confidential resume to Krisha Morander

Email  KrishaM@JMorrissey.com

see all jobs: www.jmorrissey.com

 

Krisha Morander
Director, Healthcare & Healthcare IT

Krisha Morander, a Certified Personnel Consultant, (CPC),  has over 25 years of experience in the healthcare staffing industry. She also has corporate HR Recruitment, homecare, mental health and academia background to compliment her overall knowledge of hiring talent. Krisha has been continually recognized within our agency for achieving record-high placement activity.

She places all levels of healthcare professionals within a broad spectrum of healthcare organizations across Connecticut and Massachusetts including hospitals, managed care organizations, physician practices, pharmaceutical organizations, mental health, government facilities, and long term care and rehab facilities.

In addition to her passion for clinical recruitment, Krisha also compliments her searches in the area of Information Technology. The blend of Clinical Informatics, statistics and analysis are an integrated part of measuring outcomes and data to measure surveys and scores. Krisha continues to stay connected with this evolving and complex industry through her membership with the New England Chapter of Healthcare Information and Management Systems Society (HIMSS).

Krisha majored in marketing with a concentration in Human Resources. Krisha’s industry knowledge, communication skills and passion for recruiting make her an invaluable recruiter here at J. Morrissey.


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