Business Analyst - regulatory or compliance analysis- REMOTE

Join to apply for the Contracting Analyst role at Brown University Health Join to apply for the Contracting Analyst role at Brown University Health The Contracting Analyst reports to the Director Contract Analytics and Modeling. Under general supervision produces financial and statistical reports and analytics. Assists in the establishment of appropriate contract rates and reimbursement structures and evaluates existing contract performance as well as forecasting impact of proposed contract rates. Builds and maintains payer contract models in the contract management tool. Designs and prepares accurate timely and actionable analyses financial models dashboards and reports that effectively support payer contract negotiations and payer relations strategies and decision-making. Conducts research and generates analytics to evaluate the drivers of key trends that impact contract margin performance synthesize findings and identify risks and opportunities. Implements and validates payer contract model terms including the assessment of payment variances for revenue optimization. The Contracting Analyst reports to the Director Contract Analytics and Modeling. Under general supervision produces financial and statistical reports and analytics. Assists in the establishment of appropriate contract rates and reimbursement structures and evaluates existing contract performance as well as forecasting impact of proposed contract rates. Builds and maintains payer contract models in the contract management tool. Designs and prepares accurate timely and actionable analyses financial models dashboards and reports that effectively support payer contract negotiations and payer relations strategies and decision-making. Conducts research and generates analytics to evaluate the drivers of key trends that impact contract margin performance synthesize findings and identify risks and opportunities. Implements and validates payer contract model terms including the assessment of payment variances for revenue optimization. Conducts in-depth reviews and analysis on the cost and utilization of contracts. Provides financial analysis to support contract negotiations and compliance including fee-for service bundled payments shared savings and capitated contracts. Completes annual reconciliations and settlements. Identifies and isolates problems/potential problems issues and areas for financial improvements. Develops financial strategies plans and forecasts for all fee-for-service and alternative payment models. Develops computer models and reports for tracking and evaluating performance of contracts including risk-based contracts. Assists in the planning and development of negotiation scenarios i.e. modeling various payment alternatives. Maintains effective relationships with the clinical and physician leaders IPAs and Health Plans system affiliates Corporate Services Finance Department plan representatives and Contract Managers. Maintains departmental database to track financial performance of contracts. Oversees contract reporting and quarterly performance reports. Prepares financial and statistical reports. Prepares and distributes affiliate contract financial reports. Prepares simulation models and financial Executive summaries. Functions as the finance liaison with health plan representatives. Provides value-added analytic support in the development and monitoring of standard and ad hoc cost and utilization reporting. Identifies and understands the trends and patterns of utilization and evaluates clinical/medical management programs and initiatives. Performs complex analyses. Interprets trends regulatory changes and/or forecasts and anticipates impact for members. Participates in the development and ongoing enhancement of revenue cost and utilization reporting to meet the needs of medical managers as well as business and finance managers. Leads the development of contracting reports analysis and financial reconciliations required to understand the key drivers of the relevant business unit or service line. Helps to develop the systems and processes that are the foundation for reporting and analysis. Participates as a content expert in key forums and meetings with Senior Leaders Directors Managers Medical Directors and other Executives. Supports evaluation of new and existing business opportunities through scenario modeling and financial analysis. Identifies and reports quality risks related to contract reporting. Ensures that related information is obtained documented in detail tracked and available for access and quality review. Works closely with the Central Business Office Strategic Business Planning Reimbursement/DSDS Managed Care Contracting and Utilization Management departments to identify revenue and cost savings opportunities support new product and business development regulatory compliance contract negotiations and reconciliation of incentive arrangements with other payers and vendors. Drives the development of appropriate program metrics and outcomes during the design phase of new clinical programs with an understanding of available and reliable data. Develops data queries; conducts rigorous analyses using appropriate statistical methods; Quantifies the impact of clinical initiatives on overall medical expenses and trends and works with finance and budget staff to incorporate into the appropriate financial and budget reporting. Recommendations will be based on assessment of charge structure compared to peer hospitals internal cost accounting data and claims level data. Analyzes chargemaster accuracy in accordance with regulatory requirements compliance requirements and appropriateness of bundling/unbundling. Creates ad hoc pricing reports summarizing benchmarking cost and revenue data. Bachelors Degree in Business Finance Health Administration or related field. Four to six years of experience in healthcare with a heavy emphasis in one of the following areas: reimbursement contracting financial analysis or forecasting. Strong understanding of provider reimbursement methodologies and managed care programs and contracts. Strong analytical skills including the ability to understand complex concepts develop analyses that are responsive to business needs and summarize relevant findings in a clear concise manner. Highly proficient in Microsoft Office specifically MS Excel Access and PowerPoint. Highly organized with strong project management skills including the ability to meet deadlines effectively communicate with all levels of the organization and work as part of a team. Work is performed in a typical office setting. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Brown University Health is a VEVRAA Federal Contractor. Corporate Headquarters USA:RI:Providence Work Type: Full Time Shift: Shift 1 Union: Non-Union Employment type Full-time Job function Business Development and Sales Industries Hospitals and Health Care, Medical Practices, and Mental Health Care Sign in to set job alerts for “Analyst” roles. Business Analyst Intake Specialist (Operations) - Fully Remote We’re unlocking community knowledge in a new way. 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