Reimbursement Economics Analyst
Company: Highmark Health
Location: Lincoln
Posted on: August 7, 2022
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Job Description:
**Company :**Highmark Health**Job Description :****JOB
SUMMARY**This job supports Highmark Health's Value-Based
Reimbursement, Strategy & Innovation Team. The incumbent works
closely with management and other stakeholders to develop,
coordinate, and manage analysis accompanying existing and new
reimbursement models, as well as provide analysis in the
development and support of VBR projects and information required to
make effective business decisions, and recommend innovative
approaches to VBR models and programming. Serves as a liaison among
numerous internal and external customers, including but not limited
to VBR team members, operations, actuary, provider relations,
strategic integration and advanced analytics and reporting. The
incumbent leads the development of VBR models/initiatives,
coordinating with each related business segment, and functional
area partners' work The focus of the work is the creation of a
comprehensive suite of reimbursement models that align with
enterprise goals and strategic objectives across the enterprise,
including both AHN and the Health Plan. The development of VBR
models should consider infrastructure and process development to
link medical economic related analytics (trend reporting, medical
cost, conditions, etc.) with business partner actions, including
progress and impact. Functions as point person for all business
segment medical economic analytics. Collaborates with internal
partners to identify new opportunities for VBR innovation. Manages
the organizational matrix - specifically business partners and
their respective support functions who have accountability to
implement initiatives in the portfolio. The incumbent reports into
the Enterprise and specifically with the Living Health Solution
team. There will also be significant emphasis placed on frequent
and meaningful interactions with business segment and functional
department executive/senior leadership to ensure that new
reimbursement initiatives and existing program improvements are
identified and executed in a timely manner. This will require
engagement with Health Plan Management (SVPs, VPs, Directors, etc.)
in formal and informal situations, and strong demonstration of
analytical, communicative, and influencing skills.**ESSENTIAL
RESPONSIBILITIES**+ Develop and foster relationships across the
enterprise.Provide analytical and consultative support to a broad
spectrum of internal customers and external business partners.+
Identify innovative approaches to reimbursement that capitalize on
opportunities and market inefficiencies and create value for the
organization across cost, utilization and quality.+ Lead the
maintenance/maturation of in-market VBR models and the development
of new VBR models partnering with internal stakeholders and
aligning to broader organizational strategies and goals.+ Work with
operations, reimbursement, actuary, and analytic teams to ensure
opportunities for VBR model development are based upon empirical
evidence and internal; alignning with the strategic roadmap to
ensure maximum flexibility and speed to market.+ Communicate
recommendations for VBR strategies to leadership across the
enterprise supporting organizational goals and objectives.+ Help
develop and implement improved infrastructure and processes to
provide Health Plan and Enterprise management with regular
performance scorecards highlighting initiative implementation
successes, accountability, and "capture" of initiative benefits,
activity, progress and identification of barriers.+ Consistently
work with enterprise business and functional area partners to
develop a pipeline of new VBR initiatives, seeking to achieve our
multi-year financial improvement targets.+ Serve as a resource for
the enterprise on issues related to value-based reimbursement,
including impact to organizational strategic efforts and new
programs in development at AHN and with other strategic
partners.Lead in a matrixed work environment and help drive a
culture change from "reporting the past" to "creating the solutions
for future."Collaborate with senior and executive leadership on
model builds and program design.+ Other duties as assigned or
requested.?**EDUCATION****Required**+ Bachelor's Degree in
Business, Math, Economics, Health Administration or related
field**Substitutions**+ Six years relevant experience in lieu of
bachelors degree**Preferred**+ Master's Degree in Business, Math,
Economics, Health Administration or related
field**EXPERIENCE****Required**+ 3 years in cross-functional
project team, strategy development role, and/or healthcare industry
role**Preferred**+ 3 years in Business Analyst, Business
Intelligence, Finance/Analytics**LICENSES AND
CERTIFICATIONS****Required**+ None**Preferred**+ None**SKILLS**+
Strong strong verbal/written communication skills (including
executive quality presentations)+ Analysis of business
problems/needs+ Analytical skills+ Collaborative problem solving+
Creative thinking+ Mathematics proficiency+ Strategic thinking and
development?**Language (Other than English)**None**Travel
Required**0% - 25%**PHYSICAL, MENTAL DEMANDS and WORKING
CONDITIONS****Position Type**Office-BasedTeaches / trains others
regularlyOccasionallyTravel regularly from the office to various
work sites or from site-to-siteOccasionallyWorks primarily
out-of-the office selling products/services (sales
employees)NeverPhysical work site requiredYesLifting: up to 10
poundsConstantlyLifting: 10 to 25 poundsOccasionallyLifting: 25 to
50 poundsRarely**_Disclaimer:_** _The job description has been
designed to indicate the general nature and essential duties and
responsibilities of work performed by employees within this job
title. It may not contain a comprehensive inventory of all duties,
responsibilities, and qualifications required of employees to do
this job._**_Compliance Requirement:_** _This job adheres to the
ethical and legal standards and behavioral expectations as set
forth in the code of business conduct and company policies.__As a
component of job responsibilities, employees may have access to
covered information, cardholder data, or other confidential
customer information that must be protected at all times. In
connection with this, all employees must comply with both the
Health Insurance Portability Accountability Act of 1996 (HIPAA) as
described in the Notice of Privacy Practices and Privacy Policies
and Procedures as well as all data security guidelines established
within the Company's Handbook of Privacy Policies and Practices and
Information Security Policy.__Furthermore, it is every employee's
responsibility to comply with the company's Code of Business
Conduct. This includes but is not limited to adherence to
applicable federal and state laws, rules, and regulations as well
as company policies and training requirements._Highmark Health and
its affiliates prohibit discrimination against qualified
individuals based on their status as protected veterans or
individuals with disabilities, and prohibit discrimination against
all individuals based on their race, color, religion, sex, national
origin, sexual orientation/gender identity or any other category
protected by applicable federal, state or local law. Highmark
Health and its affiliates take affirmative action to employ and
advance in employment individuals without regard to race, color,
religion, sex, national origin, sexual orientation/gender identity,
protected veteran status or disability.Highmark Health and its
affiliates prohibit discrimination against qualified individuals
based on their status as protected veterans or individuals with
disabilities, and prohibit discrimination against all individuals
based on their race, color, age, religion, sex, national origin,
sexual orientation/gender identity or any other category protected
by applicable federal, state or local law. Highmark Health and its
affiliates take affirmative action to employ and advance in
employment individuals without regard to race, color, age,
religion, sex, national origin, sexual orientation/gender identity,
protected veteran status or disability.EEO is The LawEqual
Opportunity Employer Minorities/Women/Protected
Veterans/Disabled/Sexual Orientation/Gender Identity (
_https://www.eeoc.gov/sites/default/files/migrated\_files/employers/poster\_screen\_reader\_optimized.pdf_
)We endeavor to make this site accessible to any and all users. If
you would like to contact us regarding the accessibility of our
website or need assistance completing the application process,
please contact number below.For accommodation requests, please
contact HR Services Online at
HRServices@highmarkhealth.orgCalifornia Consumer Privacy Act
Employees, Contractors, and Applicants NoticeReq ID: J211483
Keywords: Highmark Health, Lincoln , Reimbursement Economics Analyst, Professions , Lincoln, Nebraska
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