Medical Economics Analyst II

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family:

• Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance

• Paid Time Off from Day One

• 403-B Retirement Plan

• 4 Weeks 100% Paid Parental Leave

• Career Development

• Whole Person Well-being Resources

• Mental Health Resources and Support

• Pet Benefits

Schedule:

Full time

Shift:

Day (United States of America)

Address:

1051 WINDERLEY PL

City:

MAITLAND

State:

Florida

Postal Code:

32751

Job Description:

Researches and analyzes managed care data from various financial systems and interface tools. Performs complex and varied healthcare data analysis, including financial modeling and risk forecasting. Identifies and implements improvements in quality control and timeliness of reporting. Extracts, collects, analyzes, and interprets health utilization and financial data. Interprets and analyzes data from various sources using knowledge of healthcare managed care contracts and administrative claims data. Employs existing complex models and implements them on new projects and contexts. Designs new solutions for data and analytic challenges faced by the organization. Supports negotiations of capitated and other value-based agreements through detailed data analytics. Develops financial models to inform negotiation parameters. Evaluates possible changes to key terms in existing value-based agreements. Identifies risk and exposure associated with various reimbursement structures. Produces prospective analyses on new ventures, products, and service offerings. Prepares and presents analytics or project results to key stakeholders for review and decision-making. Evaluates and understands contract language related to reimbursement methodologies for various provider types. Applies detailed understanding of medical coding. Other duties as assigned.

Schedule/Shift: Monday-Friday 8am-5pm. Hybrid 3 days onsite in Maitland FL if local, Remote if located 55 miles from Maitland, FL

Knowledge, Skills, and Abilities:

• Working knowledge of value-based arrangements, including shared savings, bundled payments, pay-for-performance, and capitation [Preferred]
• Working knowledge of population health, utilization measurement, and claims analytics [Preferred]
• Managed Care, Patient Financial services, health insurance claims processing, contract management, or medical economics [Required]
• Proficiency in understanding professional and facility claims and managed care concepts such as risk adjustment, capitation, FFS, DRG, APG, APCs and other payment mechanisms [Required]
• Experience in modeling financial impact of changes [Required]
• Strong ability to handle multiple projects including problem solving, research, analysis, and communication in a fast-paced environment [Required]
• Intermediate level of proficiency working with MS Excel including Formulas, calculations, charts, and graphs [Required]
• Strong skills in analytical/problem solving and presentations [Required]

Education:

• Bachelor's [Required]
• Master's [Preferred]

Field of Study:

• in Finance, Health Care Administration, Accounting, Mathematics, or Health and Informatics or related field
• in a related field

Work Experience:

• 4+ experience performing data, financial and/or risk analytics in a healthcare environment [Preferred]

Licenses and Certifications:

• EPIC-Hospital Billing Certification (EPIC HB) [Preferred]

Physical Requirements: (Please click the link below to view work requirements)

• Physical Requirements – https://tinyurl.com/23km2677

Pay Range:

$66,830.40 – $124,300.80

Background Screening Requirement (Florida Law)

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse:
https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.