Healthcare Contract Financial Modeling Consultant (Hybrid - Detroit) - Mosaic Clinically Integrated Network

GENERAL SUMMARY:

Assisting the Manager of Contract Modeling with onboarding new employees and coaching and mentoring analysts with contract variances, simulations or contract build issues.

PRINCIPLE DUTIES AND RESPONSIBILITIES:

• Performs quarterly contract reviews to ensure models are calculating accurate expected reimbursement. Prepares summary reports with corrective action plans.
• Leads projects/initiatives requiring contract modeling and proposes recommendations for solutions and feedback to leadership.
• Coaches and mentors Analysts and assist with troubleshooting contract variances.
• Researches and resolves discrepancies between expected reimbursement and actual payments.
• Reviews Analyst contract modeling simulations for accuracy and provide feedback on opportunities for improvement.
• Independently create contract modeling simulations to evaluate reimbursement rate proposals to support the contract negotiations.
• Escalates payer contract non-compliance issues to contract administrators.
• Assists with payment validation requests.
• Executes EPSI and basic SQL reporting for ad hoc requests.
• Migrates team's updates to Production via Data courier.
• Responsible for assisting Reimbursement with monthly accruals estimates.

EDUCATION/EXPERIENCE REQUIRED:

• Bachelors Degree in Accounting, Finance, or a related field required. Masters Degree preferred.
• Minimum 10 years of experience in healthcare industry.
• Minimum five (5) years of experience in Payer Contract modeling.
• Experienced in building HB an PB contract models.
• Advanced excel skills: pivot table, VLOOKUP preferred.
• Excellent oral and written communication and presentation skills.
• Excellent organizational skills and ability to manage multiple projects simultaneously.
• Excellent interpersonal skills and ability to develop effective working relationship with both internal and external customers.
• Proficient in Microsoft Word, Excel, and PowerPoint.
• Willing to maintain flexible hours to support projects and workgroups.

Based on the needs of the Department this role will be supporting, this opportunity a best fit for someone with the following:

• Advanced critical thinking and reasoning skills.
• Self-Starter and ability to clearly document and communicate assumptions and processes.
• Strong stakeholder engagement/ reporting skills.
• Professional Rate Development experience.
• Advanced Excel and actuarial/financial modeling & Data visualization.
• Comprehensive knowledge of VBC analytics, trend analysis and KPI development (ACO model mechanics a plus).
• Tableau/Power BI/Power Query, claims data interpretation.
• Experience working with contract modeling systems (e.g., Epic contract modeling) across different types of payor arrangements.
• SQL, SAS or Python/R, data engineering - big data skills.
• Workflow mapping, data validation, feedback analysis experience.
• Ability to independently build, validate, and interpret complex financial simulations to support contract negotiations, amendments, and performance forecasting.
• Project Management Experience a plus.
• Contract analysis, stakeholder mapping, CRM tracking.

Additional Information

• Organization: Corporate Services
• Department: HF CIN
• Shift: Day Job
• Union Code: Not Applicable