Roanoke ,VA, US, 24011
How You'll Help Transform Healthcare:
Onsite is preferred, hybrid or remote work option is available. Candidates residing in the following states can be considered for remote work: Alabama, Florida, Georgia, Arkansas, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, West Virginia, and Virginia.
The Senior Medical Economics Analyst works closely with the Strategic Payment Relationships leadership to capture, integrate, transform, interpret and present healthcare data, in support of the best possible decision making and outcomes on a variety of strategic initiatives. They will lead payer analytics, payment modeling and reporting, in support of successful contract negotiations and payer performance monitoring.
• Leads modeling of commercial and government payment methodologies for all types of healthcare services: hospital, physician, ambulatory, home health, hospice, etc.
• Transforms data into analytical insights, to inform decisions for the Contracting team and Carilion executive stakeholders.
• Effectively communicates analysis to be consumed by department and executive leadership.
• Demonstrates expert knowledge of both commercial and governmental payers for modeling and analyzing contract proposals with a variety of reimbursement methodologies: case rates, DRG, fee schedules, stop loss and other contract terms.
• Leverages hospital (FinThrive) and physician (Experian MPV) claim modeling systems for enhanced payer contract analytics.
• Continuously learns and adapts to a constantly changing reimbursement environment.
• Completes extensive and complex financial and operational analyses, modeling of managed care contracts and proposals, analyze fee schedules, and determine contract performance and compliance.
• Extracts, analyzes, and synthesizes data from various sources to identify risks and opportunities.
What We Require:
Education: Bachelor's degree in finance, accounting or business-related field required. Four years of relevant experience may be considered in lieu of Bachelor's degree.
Experience: 3+ years of related experience with Bachelor's
• Extensive knowledge of commercial and government reimbursement
• Advanced knowledge of the revenue cycle
• Advanced analytical and problem-solving skills
• Advanced Microsoft Excel skills
• Clear, effective communication skills
• Detail orientation
Other Minimum Qualifications: Effective management skills including time management, communications, human relations, presentation, organizational and analytical skills. Clear and concise communication skills, both oral and written are required. Must be able to work both independently and in a team setting. Must be capable of prioritizing multiple projects and meeting deadlines. Administratively self-sufficient. Professional appearance and presentation required.
About Carilion
This is Carilion Clinic ...
An organization where innovation happens, collaboration is expected and ideas are valued. A not-for-profit, mission-driven health system built on progress and partnerships. A courageous team that is always learning, never discouraged and forever curious.
Headquartered in Roanoke, Va., you will find a robust system of award winning hospitals, Level 1 and 3 trauma centers, Level 3 NICU, Institute of Orthopedics and Neurosciences, multi-specialty physician practices, and The Virginia Tech Carilion School of Medicine and Research Institute.
Carilion is where you can make your own path, make new discoveries and, most importantly, make a difference. Here, in a place where the air is clean, people are kind and life is good. Make your tomorrow with us.
Requisition Number: 143632
Employment Status: Full time
Location: CASB - Carilion Administrative Services Building
Shift: Day
Shift Details: Monday-Friday, 8am-5pm. Additional hours as needed.
Recruiter: MARK A MISKOVIC
Recruiter Phone:
Recruiter Email: mamiskovic@carilionclinic.org
For more information, contact the HR Service Center at 1-800-599-2537.
Equal Opportunity Employer
Minorities/Females/Protected Veterans/Individuals with Disabilities/Sexual Orientation/Gender Identity
Carilion Clinic is a drug-free workplace.
Please see job description
PI233885562