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St. Mary's Good Samaritan Senior Financial Analyst - Managed Care Modeling in St. Louis, Missouri

Description

Role Purpose:

Contributes to the overall financial performance of SSM Health Care by following established policies and procedures to produce accurate and timely managed care analytics in an effective and consistent manner across the Missouri and Illinois region.

Responsibilities:

  • Ensures compliance with established processes related to the following:

  • Data integrity and reconciliation processes with managed care modeling software

  • Preparation and peer review of contract negotiation modeling reporting package
  • Preparation and peer review of quarterly Contract Performance report
  • With limited supervision, perform the necessary contract modeling in order to develop the hospital rate schedules and physician fee schedules as part of the managed care contract negotiation process.
  • Become proficient in the revenue cycle reporting tools to assist with identification or trending of revenue cycle opportunities.
  • Document and communicate revenue cycle opportunities identified through the contract modeling process to the appropriate department. Participate in meetings or conference calls as needed to explain or support position.
  • Serve as a department resource as it relates to understanding reimbursement principles and contract interpretation.
  • Participate in department and team meetings as needed in order to improve net revenue or processes related to the managed care modeling functions.
  • Keep supervisor informed of system malfunctions, problem areas, delays and other information integral to optimal performance.
  • Completes special projects related to managed care reimbursement on ad hoc basis.
Qualifications

Minimum Qualifications:

  • Bachelor’s degree in accounting, business administration or related field
  • At least 3 years of progressive experience in financial management, principally in health care and preferably in a provider environment. Experience in non-provider health care setting (insurance, consulting) can be considered in lieu of provider experience.

Preferred Qualifications:

  • Master’s degree in accounting, business administration or related field
  • CPA certification

SSM Health - System Office –

SSM Health is one of the largest Catholic health systems in the country and is dedicated to quality and compassionate care for anyone in need, regardless of ability to pay. Based in St. Louis, where its System Office is located, SSM Health operates 20 hospitals in Wisconsin, Illinois, Missouri and Oklahoma. We provide care in various settings: outpatient sites, physician offices, a pharmacy benefit company, an insurance plan, hospitals, nursing homes, home care, hospice, telehealth and a technology company.

Our Mission: Through our exceptional health care services, we reveal the healing presence of God.

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Benefits Statement:

Our robust employee benefits package includes health benefits, life and accidental death and dismemberment insurance, long-term disability coverage, health and dependent care reimbursement accounts, paid time off, tuition reimbursement, adoption reimbursement, an employee assistance program, retirement plan options and more.

Note: not all benefits apply to all openings.

Organization: SSM Health - System Office

Primary Location: Missouri-St. Louis-SSM Health System Office - 1195 Corporate Lake

Work Locations: SSM Health System Office - 1195 Corporate Lake (0033.5) 1195 Corporate Lake St. Louis, 63132

Job: Professional Services

Req ID: 18015347

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