Details: Job: Finance Acctg Billing Claims & Revenue The Analytics & Pricing Services Manager is responsible for coordination and accuracy related to What-if modeling for a defined region. The Manager must posseess the ability to direct a team at a detail level and to analyze and present modeling results at an executive level. Supervises a team of contract modelers in a defined region.Summarizes negotiations of region and related concerns to the Analytics & Pricing Services Director and Regional VP.Works at both the detail and executive level.Ensures all standard modeling processes are implemented in a region.Focuses on BUCA Payors in modeling what-if contracts for respective region - accurately and within the deadlines established to support contract negotiations.Completes testing of all contract models by service line and keeps documentation of accuracy in permanent workpaper files.Completes appropriate Proposal Approval forms with back-up documentation for review and signature by Division VP of Managed Care and CFO.Models any other managed care contracts and 'what if' scenarios as designated by SP&A negotiators or APS AVP or Director.Translates managed care contract terms that effect reimbursement and models relevant parameters.Utilizes company wide contract modeling standard processes.Organize and analyzes results data providing summary of findings related to how price changes related both CDM and rates would impact net revenue. Communicates this information to the Director and Managed Care VPs.Completes retrospective review of BUCA contracts to analyze negotiated rate of reimbursement compared to actual net revenue results with variance explanation.Participates in SSC/Managed Care payor meetings and works with payor to assist in reconciling populations and other needs.Serves as a resource for predictive modeling.Design, develop and implementation or advanced adhoc reports.Adds value to the APS by producing accurate results, working efficiently, and continuing to grow in the position.Other duties as assigned.
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