Senior Value Based Contracting Analyst – Mount Sinai Health Partners

Job Description

Background

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 Value Based Contracting (VBC) Team within MSHP is responsible for the finances related to Value Based Payments such as Shared Savings. The team serves as MSHP’s subject matter experts on: VBC related Agreements and Amendments, financial performance for all VBC contracts, VBC related contract negotiations, and distribution of Care Coordination Fees. The VBC Team serves as the spearhead in implementing Value Based Payments across the Mount Sinai Health System.


Role Summary

MSHP seeks a Value Based Contracting (VBC) Analyst to analyze and report the financial performance for all Commercial and Medicare Value Based Contracts with Mount Sinai. The VBC Analyst has responsibilities that include: analyzing medical and pharmacy trends, researching all VBC amendments, calculating per capita metrics such as cost PMPM, procuring all financial data necessary for driving Mount Sinai’s VBC model, and reconciling financial data. 

Programming in SQL required for this position.

The VBC analyst is also expected to liaise and coordinate with other departments in Mount Sinai Health Partners.

Responsibilities

• Research from the original contract amendments all Shared Savings terms, Care Coordination Fees, and Quality metrics.
• Write SQL scripts that can calculate Cost PMPM, Utilization per 1,000, and Cost per Utilization. 
• Procure and upload all VBC financial data into Mount Sinai’s Value Based Contracting Model to determine financial performance.
• Calculate Care Coordination Fee (CCF) accruals and reconcile with actual CCF received.
• Reconcile budgeted revenue vs actual revenue collected.
• Perform Root Cause Analysis on medical and pharmacy trends for all VBC contracts.
• Maintain and update VBC factsheet on Shared Savings, Care Coordination Fees, and Quality. 
• Create Power Point Presentations detailing any analysis regarding VBC performance.
• Collaborate and liaise with other departments such as Medical Economics, Finance, Clinical Informatics, and Strategy.


Qualifications 

Education and Experience
• Bachelor’s Degree required; Master’s Degree in Public Health, Business Administration or related field preferred. 
• At least three to five years of experience working for a healthcare organization, health plan or other insurance or consulting organization; experience in Healthcare Economics or Value Based Payments is strongly preferred.
• At least one year experience in Healthcare Analytics and SQL programming experience required.

Additional Skills and Qualities
• Understanding of Excel functions such as VLOOKUP, Pivot Tables, and SUMIFS.
• Basic understanding of statistical concepts such as per capita, weighted averages, variances, and forecasting.
• Experience analyzing Facility, Professional and Pharmacy cost trends.
• Familiarity with amendments between payers and providers.
• Firm understanding of Facility, Professional and Pharmacy claim reimbursement.
• Oral presentation experience, especially with senior management, highly recommended.
• Understanding of data and financial reconciliation. 

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