Experience Inc. Jobs

JOB DESCRIPTION

Mount Sinai is one of the largest U.S. health systems with a strong reputation for quality of care and research. We have over 38,000 employees working together to provide billions of dollars in high-quality care each year for millions of patients.

We are accelerating a transition to a business model focused on population health management – our goal is to keep entire communities healthy and out of the hospital. Mount Sinai Health Partners (MSHP) is the team driving this transformation within Mount Sinai. The team includes 400+ employees with clinical, contracting, finance, IT, analytics, operations, and product development expertise.

MSHP is a fast growing business unit within Mount Sinai and is looking for team members who:

• Are comfortable “playing up” and “playing down” as needed to accomplish business objectives

• Work productively amidst ambiguity

• Thrive in fast-paced work environments

• Seek to improve the status quo

What We Offer

• Opportunity for advancement within MSHP team

• Opportunity to work directly with senior leaders from across the Mount Sinai Health System and external organizations

• Opportunity for mentorship from senior MSHP leaders

• Opportunity to be part of a forward-thinking team driving a system-wide transformation

• Opportunity to work at the forefront of innovation in healthcare

The Managed Care Contracting Team within MSHP is responsible for the negotiation, implementation and contract compliance related to Facility Contracts for all Commercial, Medicare Advantage and Medicaid Managed Care Plans. The team serves as MSHP’s subject matter experts on: Facility related Agreements and Amendments, financial performance for all contracts, and facility, ancillary related contract negotiations. The Managed Care Team is at the forefront of implementing Facility and Ancillary Contracts across the Mount Sinai Health System.

MSHP seeks a Senior Contracting Analyst to analyze and report the financial performance for all Commercial and Medicare Contracts with Mount Sinai. The Senior Contracting Analyst has responsibilities that include: analyzing medical and pharmacy trends, researching all facility amendments, procuring all financial data necessary for driving Mount Sinai’s Facility models, and reconciling financial data. The Senior Contracting analyst is also expected to liaise and coordinate with other departments in Mount Sinai Health Partners.

RESPONSIBILITIES

• Research from the original contract amendments all financial terms.

• Write SQL scripts that can calculate Cost, Revenue and Cost per Utilization.

• Procure and upload all financial data into Experian Contract Manager Tool to determine financial performance.

• Model Payer Proposals in Experian Contract Manager Tool.

• Reconcile budgeted revenue vs actual revenue collected.

• Perform Root Cause Analysis on medical and pharmacy trends for all contracts.

• Create Power Point Presentations detailing any analysis regarding facility contracting performance.

• Collaborate and liaise with other departments such as Commercialization, Finance, and Patient Accounts.

• Responsible for overall management and delivery of the business plan. Financial analysis and creation of reports as requested by department administrator or chairman as applicable

• Compiles productivity, compliance and profit/loss reports

• Analyzes revenues to identify collection problems, billing issues and other trends.

• May be well versed and take a proactive role in the revenue cycle, which includes all administrative and clinical functions that contribute to the capture, management and collection of patient service revenue, including overseeing those who may counsel patients on how best to meet their financial obligations.

• Reviews processes and makes recommendations to implement effective changes in procedures and policies.

• Assists with or leads special projects and provides analytical support.

• Performs other related duties

QUALIFICATIONS

Education and Experience

• HS/GED; Bachelors strongly preferred. Additional experience needed in addition to “experience requirements” listed below in lieu of education.

• At least seven years of experience in healthcare analytics required (with a Bachelors degree).

• Health plan experience in Medical Economics or Value Based Payments preferred.

Additional Skills and Qualities

• Understanding of Excel functions such as VLOOKUP, Pivot Tables, and SUMIFS required.

• Basic understanding of statistical concepts such as per capita, weighted averages, variances, and forecasting required.

• Experience analyzing Facility, Professional and Pharmacy cost trends preferred.

• Familiarity with amendments between payers and providers preferred.

• Firm understanding of Facility, Professional and Pharmacy claim reimbursement preferred.

• Oral presentation experience, especially with senior management, preferred.

• Understanding of data and financial reconciliation preferred.

, E01 - Partner MSO Services - MSH, Mount Sinai Hospital

ABOUT US

Strength Through Diversity

The Mount Sinai Health System believes that diversity, equity, and inclusion are key drivers for excellence. We share a common devotion to delivering exceptional patient care. When you join us, you become a part of Mount Sinai’s unrivaled record of achievement, education, and advancement as we revolutionize medicine together. We invite you to participate actively as a part of the Mount Sinai Health System team by:

• Using a lens of equity in all aspects of patient care delivery, education, and research to promote policies and practices to allow opportunities for all to thrive and reach their potential.

• Serving as a role model confronting racist, sexist, or other inappropriate actions by speaking up, challenging exclusionary organizational practices, and standing side-by-side in support of colleagues who experience discrimination.

• Inspiring and fostering an environment of anti-racist behaviors among and between departments and co-workers.

At Mount Sinai, our leaders strive to learn, empower others, and embrace change to further advance equity and improve the well-being of staff, patients, and the organization. We expect our leaders to embrace anti-racism, create a collaborative and respectful environment, and constructively disrupt the status quo to improve the system and enhance care for our patients. We work hard to create an inclusive, welcoming and nurturing work environment where all feel they are valued, belong and are able to advance professionally.

Explore more about this opportunity and how you can help us write a new chapter in our history!

“About the Mount Sinai Health System:

Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,400 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 14 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.

The Mount Sinai Health System is an equal opportunity employer. We comply with applicable Federal civil rights laws and does not discriminate, exclude, or treat people differently on the basis of race, color, national origin, age, religion, disability, sex, sexual orientation, gender identity, or gender expression. We are passionately committed to addressing racism and its effects on our faculty, staff, students, trainees, patients, visitors, and the communities we serve. Our goal is for Mount Sinai to become an anti-racist health care and learning institution that intentionally addresses structural racism.”

EOE Minorities/Women/Disabled/Veterans

Requisition ID : 3017566