Sr Manager Government Analytics

Job Summary

The Sr. Manager Governmental Analytics is the responsible leader over Nicklaus Children's financial preparation/modeling/forecasting related to Medicaid funding. Lead and participate in analytics support for all payer strategy initiatives. Provide analytics/trending reporting related to Ensemble Rev Cycle teams- Patient Access, Utilization Mgt, and underpayments as it relates to payer-related issues. Supporting the VP Population Health/Payer Strategy with all governmental strategic initiatives for Nicklaus Children's South, North, and future region expansion. Support in Epic/FinThrive at the Broward, as well as future transition to Epic contract modeling. Learn and develop innovative enhancements and analytics for all Governmental, Commercial and Value Based payment initiatives. Develop complex financial analytics packages and models used during negotiations and other initiatives for the Vice President of Population Health and Payer Strategy. Serve as the lead Medicaid/Legislative Session Financial expert to Senior Leadership within the health system with expanded role working with Statewide Children's Hospital's CFOs and Government Relations leadership.

Job Specific Duties

• Performs and leads complex analytics on Medicaid and Commercial proposals; evaluates financial impact and makes well thought out, logical recommendations.
• Supports contract negotiations with financial analysis that ties together complex, multidisciplinary concepts impacting reimbursement.
• Continuously maintains, creates, and implements automated reporting mechanisms to effectively manage Medicaid, Managed Care, and Value Based business by providing proactive trending/impact by key metrics and statistics.
• Participates in ongoing research of governmental regulations and policies to ensure impact to NCHS/NCPS financial/clinical operations are understood, communicated timely & effectively.
• Works with Senior Leadership on Legislative priorities and complex financial models.
• Continuous engagement and awareness in AHCA related initiatives impacting funding and reimbursement to Children's Hospitals.
• Works cross functionally to operationalize systems and organizational changes required of the task at hand.
• Learns & understands healthcare industry value transformation to continuously tie it back to NCHS Foundational Pillars and successfully incorporates into daily work functions.
• Plays lead role in representing Nicklaus in the Directed Payment Program by developing playbooks on timelines and analytics in support of program and by working closely with outside strategy consultants and attending monthly Statewide and Regional strategy calls.
• Creates and manages a payer data cube to facilitate in depth financial analysis containing various levels of complexity and data slices.
• Manages the analytics planning, support and recommendations to the VP Population Health/Payer Strategy for all NCPS Managed Care Agreements.
• Leads the analysis of NCPS managed care agreements related to MPIP and other Medicaid reimbursement structures.

Minimum Job Requirements

• Bachelor's Degree in Business Administration, Healthcare Administration, or related field
• 7-10 years of experience in analytics, forecasting, and executive presentations related to Medicaid financing/reimbursement.

Knowledge, Skills, and Abilities

• Master's degree in Business, Healthcare Administration, or related field preferred.
• Experience with FinThrive (previously known as MedAssets) or similar contract management tool system preferred.
• Ability to grasp new concepts and respond to ever changing priorities effectively and timely.
• Commitment to excellence.
• Excellent listening and communication skills.
• Experience serving on the core leadership team responsible for complex managed care payer negotiations on behalf of hospitals and physician groups.
• Extensive experience using Business Intelligence systems.
• Advanced Excel modeling, formulas, and automation skills.
• Ability to manipulate large data sets and transform into usable and relevant information in support of strategic asks.
• Excellent verbal and written communication skills.
• Able to maintain confidentiality of sensitive information.
• Ability to problem solve and formulate a plan of action.
• Able to analyze and audit contracts; ability to understand the big picture and focus in on appropriate areas to model and assess financial impact.
• Strong ability to multitask and pivot as needed.
• Able to execute and follow through on tasks.
• Knowledge of reimbursement terminology and contract testing.
• Knowledge of all payer healthcare reimbursement methodologies (government and non- government).
• Demonstrates competency in financial and statistical reporting, design, preparation of spreadsheets, and other financial reports.
• Strong problem-solving skills; open and adaptable to constructive criticism.
• Skills in the use of complex mathematical and statistical techniques.
• Possess demonstrated leadership skills focused on continuous growth and development of direct reports.
• Understand Rev Cycle front to back-end integration with managed care.
• Demonstrated leadership, development, and management of direct reports.