Sr. Financial Analyst- Managed Care (Hybrid)

This role will work a hybrid shift based in Stamford, CT. Hybrid work must take place from CT, NY, or NJ.

This senior-level position is responsible for the strategic planning, negotiation, and end-to-end management of complex managed care contracts for Stamford Hospital, Stamford Health Medical Group, and Stamford Health-Norwalk Radiology, LLC. The role serves as the primary analytical lead in payer negotiations, delivering strategic insights into reimbursement structures, payment variances, and contribution margins. This role drives profitability through advanced contract modeling, proactive performance auditing, and collaboration with leadership to align managed care strategies with organizational growth, operational efficiency, and financial goals.

MAJOR ACCOUNTABILITIES/CRITICAL RESPONSIBILITIES:

• Strategic Negotiation & Contracting: Assist in negotiations with managed care organizations (MCOs) to secure favorable, market-competitive provider agreements. Translate complex reimbursement methodologies into actionable contract language, ensuring alignment with the Health System''s financial targets and strategic growth plans.
• Advanced Contract Modeling & Database Strategy: Build, validate, and maintain sophisticated reimbursement models (e.g., Epic/contract modeling software) to project net expected revenue and simulate the financial impact of proposed contract changes.
• Comprehensive Contract Portfolio Management: Oversee the complete repository of managed care contracts, ensuring 100% accurate implementation of terms. Proactively identify operational or financial discrepancies between contract terms and payer performance.
• Financial Analysis, Reporting & ROI Optimization: Perform deep-dive contribution margin analysis, service line reporting, and payor performance auditing to identify revenue opportunities. Provide actionable, high-level recommendations to senior management regarding payer behavior, reimbursement trends, and margin improvement.
• Payer Relations & Problem Solving: Serve as the subject matter expert and primary contact for escalated payer contract issues, ensuring resolution to payment variance and denial issues. Proactively manage the provider escalation process to maximize revenue capture.
• Market & Value-Based Program Intelligence: Analyze the external payer environment, including fee schedule changes, regulatory shifts, and Value-Based Purchasing/pay-for-performance metrics to ensure compliance and optimize incentive payments.
• Leadership & Cross-Functional Collaboration: Partner with service line leaders, Revenue Cycle Management, and Finance to ensure contract terms reflect clinical operations. Mentor junior analysts on contract interpretation and modeling best practices.

QUALIFICATIONS/REQUIREMENTS:

• A Bachelors degree in business, finance, healthcare administration, or a related field is required.

• Minimum of 3 years of experience in managed care contracting, payor relations, or hospital decision support/reimbursement.

• Expert proficiency in Microsoft Excel (complex modeling) and experience with contract modeling software (Epic Resolute HB/PB Expected Reimbursement contracting preferred).

• Strong analytical and critical thinking skills to analyze large datasets and financial reports.

• Excellent oral, written, and interpersonal communication skills for internal and external interactions, senior-leadership level presentations.

At Stamford Health, we believe that every patient deserves compassionate, personalized, person-centered care. This commitment guides how we care for patients, support their care partners, and promote the wellbeing of our staff. In alignment with our Planetree philosophy, the individual in this role will foster a respectful, collaborative environment that honors the needs, values, and preferences of every person we serve and the colleagues we partner with.