Allegheny Health Network Careers

Job Title:  Senior, Financial Analyst Managed Care
Req Number: 51129
Location: Corporate Office

Allegheny Health Network is an integrated delivery network focused on preserving health care choice and providing affordable, high-quality care to the people in our communities. With more than 14,000 employees including 7,400 health care professionals, nearly 200 primary care and specialty care practices, Allegheny Health Network includes seven hospitals in Pennsylvania with nearly 2,400 licensed beds.

Allegheny Health Network’s clinical expertise ranges from primary care to the most complex surgical procedures. Services include cancer diagnosis and treatment, cardiovascular care, neurological and neurosurgical services, organ transplantation, orthopedic and rehabilitation services, and women’s health.

Department: Revenue Cycle
Status: Full Time

JOB SUMMARY:

Responsible for financial analysis for managed care contracting, data analysis for high-level negotiations and project management for managed care and related operations. Develops, coordinates, performs and communicates activities necessary to support the managed care operations of AHN. Responds directly to directly to Director, Managed Care.

RESPONSIBILITIES:

• Responsible for analyzing and summarizing contract performance data demonstrating projected vs. actual increase or decrease to revenues, level of denials, timeliness of payment, underpayments and overpayments.
• Maintaining and auditing contract terms in EPIC Patient Billing System.
• Responsible for the accurate and timely operation of complex modeling application (MedAssets) to prepare offers and counter offers on managed care agreements. Provide comprehensive reports to executive management related to impact of various rate changes, down to the product line, facility or sub-speciality provider.
• Responsible for supporting supplemental vendors used to perform various projects in Finance and other departments such as Charge Master Analysis, new products, joint ventures, etc.
• Works on special assignments within the Managed Care Department that address revenue enhancement projects, including dashboard and scorecard reports for tracking appeals of inappropriate reimbursements from Managed Care Payors and help with the development of a comprehensive Quality Assurance/Quality Improvement (QA/QA) program across various areas of the WPAHS organizations as directed by executive staff.
• Perform all related duties or special projects as assigned/required and stays abreasst of issues impacting thebhealthcare industry, especially those that have a financial impact to WPAHS.

RESPONSIBILITIES:

Education: BS/BA degree required. Master's degree, fellow of healthcare financial management or equivalent experience preferred.
Licensure/ Certification/Registration: Certification in QA programs such as Six Sigma or Lean Process Improvement are helpful but not required. Fellow of Healthcare Financial Management Association helpful but not required.
Complexity of Work:  Works collaboratively with various operating, finance and other areas of the healthcare system to address a multitude of complex data and process operational issues. This is a high skilled, high profile positon within the department and across the institution. Requires a high degree of interpersonal relationship building focused on developing confidence in the department's production. Interpersonal skills also must be focused on high customer service effort. Independently performs most assignments with limited guidance provided on complex problems.
Required Experience:  4 years’ experience as a healthcare or hospital financial analyst required (2 years can be replaced by Master's degree). Healthcare experience in patient accounts, managed care, decision support or finance. Significant experience and expertise in Microsoft office, especially excel, PowerPoint and access required. Knowledge of government programs such as Medicare and Medical Assistance. Knowledge of various patient accounting systems (i.e.c, EPIC, SMS Invision, Affinity, Meditech, Allscripts). Knowledge of various insurance products commercial, medicare and medicaid. Report writing tools such as crystal reports and microsoft office products highly desired.