Trinity Health Manager, Payer Analytics in Livonia, Michigan

POSITION PURPOSE The Manager of Payer Analytics is responsible for the development of reporting, analytic and financial activities related to Trinity Health's fee for service contracting including strategic financial and business impact, financial analysis and trends related to payer and contract analysis. This critical position within the Medical Economics Department will also be responsible for leading a team of colleagues to maintain net revenue calculations, provide contract modeling through the use of current applications and prioritize and track analytic work assignments. Designs and implements appropriate controls and prepares, monitors and analyzes key performance indicators and service level agreement targets. Ensures the integrity of the accuracy of net revenue calculations and coordinates work processes and communications with other revenue cycle functional teams. Identifies all risk associated with the accuracy of the application and keeps the Director apprised of risk and develops risk management plans. This position will lead and assist in the preparation of standard and ad-hoc reports, analytics, business case development and present analytic findings and recommendations.

ESSENTIAL FUNCTIONS

Knows, understands, incorporates, and demonstrates the mission, vision, and values of Trinity Health in behaviors, practices, and decisions.

Responsible for managing all financial and compliance risk associated with the patient account claim valuation application, notifying departmental leadership of identified risks and developing and implementing risk management plans.

Builds strong, collaborative partnerships between Medical Economics and other operating groups within Trinity Health to facilitate and drive key deliverables. Develops credibility for the organization by providing timely, accurate and actionable analytic data to key stakeholders.

Establishes strategies and goals for colleagues, manages resources within budget targets, coordinating allocation of staff resources assigned to achieve optimal outcomes.

Performs all managerial tasks associated with effective day-to-day operations of a team of individuals and the medical economics function.

Manages and coordinates the use of the contract analytical application throughout Trinity Health. Works collaboratively with ITS and vendor staff in support of Trinity Health objectives including education, implementation and upgrading of the application.

Proactively monitors and continually refines the claim valuation and payer contract modeling process. Supports the development of aggressive and integrated strategies and interventions regarding analytics, dashboards and reporting packages.

Participates on and leads various operational multi-functional project teams. Conducts external research and data gathering; business analyses; process mapping and workflow analysis, and creates dashboards benchmarking against key performance indicators.

Publishes and monitors policies and procedures to ensure Payer Strategies & Product Development practices and reporting adhere to compliance regulations.

Participates in the strategic development of analytic and technical resources necessary to support business relationships related to existing and new products and markets. Provides analysis to support business decisions, defining the estimated financial impact of such decisions.

Interprets 3rd party payer contract language and recommends, designs and implements procedures for compliance with best practice language and standards.

Communicates effectively and maintains collaborative working relationships with all stakeholders including senior management and colleagues, Regional Health Ministry leadership and colleagues, third party payers, and vendor partners.

Manages and leads large and small-scale projects of a limited duration. Works with team members by applying project management methods and leveraging project management acumen in order to achieve identified milestones and outcomes

Manages the reporting process and reconciliation of related applications to ensure integrity of data. Manages the design and implementation of appropriate controls. Generates communication and work process plans for improvement of data integrity.

Maintains a working knowledge of applicable Federal, State and local laws/regulations; the Trinity Health Integrity and Compliance Program and Code of Conduct; as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.

Performs other duties as needed and assigned by the Director of Payer Analytics.

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Job Number: 00071836

Location: Livonia, MI

Organization Name: Trinity Health

Facility: SO - Trinity Health System Office

Employment Type: Full time

Shift: Day Shift

Hours: 40