Manager, Contract Economics and Reporting – Mount Sinai Health Partners

Job Description

 

 

The Mount Sinai Health System

              Manager, Contract Economics and Reporting

              Managed Care Contracting Department

Background

 

The Mount Sinai Health System (MSHS) is one of the largest non-profit health systems in the U.S. with a strong reputation for quality of care and research/education.   Our health system has ~42,000 employees working together to provide billions of dollars of high-quality care for millions of patients each year.  

 

We are accelerating our transition to a population health management business model with a goal to help entire communities achieve optimum health through active engagement with MSHS care givers. Mount Sinai Health Partners (MSHP) is the team driving this transformation within the Mount Sinai Health System.  The team includes 400+ employees with clinical, contracting, financial, IT, analytics, operations, and product development and commercialization expertise.  MSHP is a fast growing business unit within the Mount Sinai Health System and is looking for team members who:

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

Ø  Work productively and decisively in an emerging  fluid environment

Ø  Thrive in fast-paced  work environments

Ø  Are hands on, willing to roll up their sleeves and dive in to get the job done

Ø  Seeks to improve the status quo 

 

Within MSHP, the Managed Care Contracting group is responsible for negotiating contracts with payers for hospital, professional, ancillary and value and risk based services.  The team manages these relationships and contract performance to ensure optimal financial and operational performance.

 

Role Summary

 

The Manager, Contract Economics and Reporting (Manager) is responsible for overseeing the financial modeling of Value Based, Shared Savings, Bundled Payments and Risk Managed contracts for the Commercial, Medicare and Medicaid populations, in alignment with the Mount Sinai Health Partners (MSHP) strategic plan and the New York State Value Based roadmap. The Director, Value and Risk Contracts will support the structuring and negotiation of the contracts in order to provide senior leadership with a complete understanding of both forecasted and historical financial results of the contracts in the MSHP portfolio. The Manager shall also be responsible for overseeing assigned contracts within the (MSHP) division to ensure optimal financial results and make data driven suggestions based upon ad hoc analyses of how to best structure and perform under the contracts. The Manager will also lead the development of the MSHP financial close process and forecasting plan, ensuring actual and forecasted revenues from all Value and Risk Based contracts are updated at least quarterly with current estimates of contract performance to be provided to the Finance organization.  This position reports to the Vice President, Value and Risk Contracting. 

 

 

 

 

 

Responsibilities

 

1.       Under direction of the Vice President, Value and Risk Contracting, ensures financial models are developed to reflect terms of all value based contracts.

2.       Works with Senior Director, Value and Risk Contract Support to convert MSHP’s various contract terms into a financial model that can forecast multi year pro forma performance.  Requires Boolean logic and other advanced Excel tools including the use of macros and statistical functions.

3.       Works with the actuarial informatics department to develop “early warning” systems on contract performance based upon sets of information provided by payers and internal systems to inform the contract models.

4.       Supports the development and maintenance of the revenue portion of the MSHP P&L and develops a close process around the P&L. Works with Chief of Staff of MSHP and Finance team of Mount Sinai Health System to provide output needed for each of their respective areas.

5.       Develops sensitivity analyses to test variables for largest impact to help guide and support negotiation of contract terms and understand where the highest ROI for clinical activities are available.

6.       Works with MSHP leadership staff to support the financial revenue forecast process by developing annual budgets, quarterly forecasts, and 3-year strategic plans in conjunction with expected performance of contracts.

7.       Reviews contracts before contract execution to sign off on congruity between financial model and terms in the contract especially for any and all financial exhibits contained within the contract.

8.       Identifies best practices and work with Vice President and Senior Director, Value and Risk Contract Support to ensure those practices are introduced into contracts at the time of the next negotiation.

9.       Compiles and tracks financial and statistical information related to contract development and financial impact analysis.

10.   Serve as a liaison between payers and health system related to financial modeling matters on assigned Value Based, Shared Savings, and Risk Managed contracts.

11.   Participates directly and indirectly in the contracting process with Large Groups, IPAs, Vendors, and Facilities.

12.   Manages accountabilities and work plans, delegates tasks and responsibilities to extra-departmental resources required to ensure objectives are met. 

13.   Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; benchmarking state-of-the-art practices; participating in professional societies.

14.   Improve financial status by analyzing results and variances; identifying trends; recommending actions.

15.   Compiles and tracks financial and statistical information related to contract development and financial impact analysis.

16.   Responds to inquiries and interprets contract language as it relates to agreements.

17.   Directly and indirectly participates in the negotiations of Shared Savings, Value Based, and Risk agreements.

18.   Maintain and publish contract summaries.

19.   Oversee and update contract dashboards, ensuring data accuracy and appropriate distribution.

20.   Performs all other duties as assigned.

21.   Participates in the department’s performance improvement activities.

22.   Maintains patient/employee confidentiality in the management of information.

23.   Observes the health care system’s compliance policies.

24.   Ensures proper care of departmental facilities, equipment, and supplies.

 

Collaboration and Leadership

Collaborates with other business units to understand strategic goals and promote an environment conducive to creativity, change and information exchange.

 

Assists in the training, coaching, mentoring of staff in accordance with all internal policies and procedures. Communicates values, strategies, and objectives of department or division on a regular basis. Assigns accountabilities, delegate’s tasks and responsibilities as appropriate.

Qualifications                    

 

 

Education and Experience

  • BA required, MBA or advanced degree in related business or health care area preferred.  
  • Minimum of 7 years’ experience in value and risk contracts and financial modeling. 
  • Minimum of 7 years’ experience in hospital and professional reimbursement and contracting.
  • Demonstrated experience in contract implementation and compliance.
  • Demonstrated experience in business development.
  • Demonstrated experience in financial performance data analytics, forecasting, and reporting tools for contracting arrangements.
  • Superior written and verbal communication skills.

 

Additional Skills and Qualities

  • Advanced abilities in Microsoft Office Suite (Word/Excel/PowerPoint), and VBA.

·         Clearly conveys information, data and concepts in a manner which engages the audience and helps them understand and retain the message.

·         Identifies and understands issues, challenges and opportunities; comparing data from different sources to formulate conclusions, develop an effective course of action or appropriate solution and follow through to ensure appropriate closure. Takes action consistent with available facts, constraints, and probable consequences.

·         Maintains effectiveness when experiencing opposition, working under pressure or during major changes in work responsibilities or environment; adjusts effectively to work within new work structures, processes, requirements, or cultures.

·         Interacts with others to build trust and provide confidence in one’s intentions and those of the organization.

·         Sets high goals for personal and group accomplishments using measurable methods to monitor progress, tenaciously working to meet or exceed goals.

·         Provides feedback, instruction, and development guidance to help others excel in their current or future job responsibilities.

 

 

 

 

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