Healthcare Contract Financial Modeling Consultant (Hybrid - Detroit) - Mosaic Clinically Integrated Network
GENERAL SUMMARY:
Assisting the Manager of Contract Modeling with onboarding new employees and coaching and mentoring analysts with contract variances, simulations or contract build issues.
PRINCIPLE DUTIES AND RESPONSIBILITIES:
- Performs quarterly contract reviews to ensure models are calculating accurate expected reimbursement. Prepares summary reports with corrective action plans.
- Leads projects/initiatives requiring contract modeling and proposes recommendations for solutions and feedback to leadership.
- Coaches and mentors Analysts and assist with troubleshooting contract variances.
- Researches and resolves discrepancies between expected reimbursement and actual payments.
- Reviews Analyst contract modeling simulations for accuracy and provide feedback on opportunities for improvement.
- Independently create contract modeling simulations to evaluate reimbursement rate proposals to support the contract negotiations.
- Escalates payer contract non-compliance issues to contract administrators.
- Assists with payment validation requests.
- Executes EPSI and basic SQL reporting for ad hoc requests.
- Migrates team's updates to Production via Data courier.
- Responsible for assisting Reimbursement with monthly accruals estimates.
EDUCATION/EXPERIENCE REQUIRED:
- Bachelors Degree in Accounting, Finance, or a related field required. Masters Degree preferred.
- Minimum 10 years of experience in healthcare industry.
- Minimum five (5) years of experience in Payer Contract modeling.
- Experienced in building HB an PB contract models.
- Advanced excel skills: pivot table, VLOOKUP preferred.
- Excellent oral and written communication and presentation skills.
- Excellent organizational skills and ability to manage multiple projects simultaneously.
- Excellent interpersonal skills and ability to develop effective working relationship with both internal and external customers.
- Proficient in Microsoft Word, Excel, and PowerPoint.
- Willing to maintain flexible hours to support projects and workgroups.
Based on the needs of the Department this role will be supporting, this opportunity a best fit for someone with the following:
- Advanced critical thinking and reasoning skills.
- Self-Starter and ability to clearly document and communicate assumptions and processes.
- Strong stakeholder engagement/ reporting skills.
- Professional Rate Development experience.
- Advanced Excel and actuarial/financial modeling & Data visualization.
- Comprehensive knowledge of VBC analytics, trend analysis and KPI development (ACO model mechanics a plus).
- Tableau/Power BI/Power Query, claims data interpretation.
- Experience working with contract modeling systems (e.g., Epic contract modeling) across different types of payor arrangements.
- SQL, SAS or Python/R, data engineering - big data skills.
- Workflow mapping, data validation, feedback analysis experience.
- Ability to independently build, validate, and interpret complex financial simulations to support contract negotiations, amendments, and performance forecasting.
- Project Management Experience a plus.
- Contract analysis, stakeholder mapping, CRM tracking.
Additional Details
This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.
Overview
Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services – from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford’s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation’s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at henryford.com/careers.
Benefits
The health and overall well-being of our team members is our priority. That’s why we offer support in the various components of our team’s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.
Equal Employment Opportunity/Affirmative Action Employer
Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is
committed to the hiring, advancement and fair treatment of all individuals without regard to
race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,
weight, marital status, family status, gender identity, sexual orientation, and genetic information,
or any other protected status in accordance with applicable federal and state laws.