Analyst, Payer Relations

Welcome to Ovation Healthcare! At Ovation Healthcare (formerly QHR Health), we’ve been making local healthcare better for more than 40 years. Our mission is to strengthen independent community healthcare. We provide independent hospitals and health systems with the support, guidance and tech-enabled shared services needed to remain strong and viable. With a strong sense of purpose and commitment to operating excellence, we help rural healthcare providers fulfill their missions. The Ovation Healthcare difference is the extraordinary combination of operations experience and consulting guidance that fulfills our mission of creating a sustainable future for healthcare organizations. Ovation Healthcare’s vision is to be a dynamic, integrated professional services company delivering innovative and executable solutions through experience and thought leadership, while valuing trust, respect, and customer focused behavior. We’re looking for talented, motivated professionals with a desire to help independent hospitals thrive. Working with Ovation Healthcare, you will have the opportunity to collaborate with highly skilled subject matter specialists and operations executives, in a collegial atmosphere of professionalism and teamwork. Ovation Healthcare’s corporate headquarters is located in Brentwood, TN. For more information, visit www.ovationhc.com. Summary: The Payor Relations Analyst Consultant is responsible for supporting Payor Relations Team through data management and analysis. This role is responsible for managing the modeling process, contract performance vetting data, managing All Payor hospitals, providing accurate deliverables and assisting with deliverables as needed. Duties and Responsibilities:

• Collect and validate data from hospitals for modeling, analytics, and presentation.
• Evaluate existing and proposed payer contracts to determine financial feasibility and impact on the organization’s bottom line.
• Model Portal – Maintain all request for all hospital models and maintain tracker
• Analyze and interpret complex managed care contract proposals, including reimbursement methodologies, and load or update contract terms in the designated contract management system.
• Manage data validation for all databases. Audit and monitor claim payments from managed care plans to ensure accurate reimbursement according to contract terms. Investigate payment variances and discrepancies, identifying root causes for underpayments.
• Assist with data analysis and create tables and forms for Presentation.
• Monitor and manage assigned deadlines for models. Including tracker maintenance and internal communication with consultants
• Assist with regular/ad hoc reporting requests, dashboards for management on payer mix, financial performance, and compliance metrics.
• Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems.
• Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations.
• Graphically/analytically strong; excellent analytical, critical thinking, and problem-solving skills, with meticulous attention to detail. Strong communication skills to effectively present complex data to both technical and non-technical stakeholders.
• Track and report on Key Performance Indicators (KPIs) Additional responsibilities:
• Assist with validating financial analysis prior to presenting to hospital or payers
• Maintain and organize client information
• Assist leadership with annual team goals QUALIFICATIONS:
• Minimal travel
• Understanding of managed care contracting and related initiatives are useful but not required as well as the underlying systems that support those initiatives.
• Understanding of Revenue Cycle process is useful but not required.
• BS Preferred
• Advanced knowledge of Microsoft products Excel (VLOOKUPS, Pivot tables, data modeling)
• Familiar with Microsoft Power Point / Power BI
• Experience with Electronic Health Records (EHR) and Billing Systems (i.e. Epic, Cerner) preferred
• Ability to interact with clients and strong communication skills
• Team player
• Organizational skills / multitasking
• Data analysis experience critical
• Critical thinker
• Problem solving skills
• Ability to work in a fast-paced environment independently Apply tot his job

Apply tot his job Apply To this Job