What are the responsibilities and job description for the Healthcare Contract Financial Modeling Consultant (Hybrid - Detroit) - Mosaic Clinically Integrated Network position at Detroit) - Mosaic Clinically Integrated Network - Henry Ford Health - Careers Careers?
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 Information