Provides analytical depth and expertise to substantiate strategic growth, and delivers leadership to the Phoenix Children’s enterprise and analytics teams to enable effective maintenance of contract and payer data, reimbursement modeling, trend analysis, financial proposal development, contract term optimization, risk analysis and payer financial performance audits in a highly matrixed environment. The Manager, Managed Care Data and Analytics is responsible for the direction and oversight of analytics and reporting to support managed care contracting, financial reporting and network reporting. He/She oversees and/or participates in multiple cross-collaborative project teams. The Manager, Managed Care Data and Analytics is responsible for developing, leading, and communicating innovative strategies and tactics to support the managed care contract life-cycle in a fast paced, high volume setting. He/She leads the Data and Analytics team to deliver high quality outcomes and results within expected timeframes.
- Family-Centered care that focuses on the need of the child first and values the family as an important member of the care team
- Excellence in clinical care, service and communication
- Collaborative within our institution and with others who share our mission and goals
- Leadership that set the standard for pediatric health care today and innovations of the future
- Accountability to our patients, community and each other for providing the best in the most cost-effective way.
Managed Care Data Support
- Oversees analytical team in the extraction, aggregation and quality assurance of data from multiple sources in support of managed care for a variety of contracting methodologies, which may include fee for service, value-based, shared savings, and risk-based contracting. Ensures projects are completed in accordance with deliverable deadlines.
- Directs the development and execution of analytical activities to provide senior leadership with timely information and tools for strategic decision making and planning, health care utilization and costs, reimbursement projects and issues, trends and forecasting, data and informatics needs. Represents Managed Care Analytics at appropriate leadership meetings and participates in and proactively contributes to internal highly matrixed teams. Partners with contracting, clinical, and operations teams to develop strategies around contracting methodologies, and financial models.
Data and Analytics Quality
- Ensures consistency of approach related to analysis techniques, key findings, and the developments of recommendations/opportunities. Ensures analytics team maintains full compliance with internal and external guidance and regulations, including applicable policies and codes. Determines opportunities and identifies solutions to improve capabilities and efficiency of reporting. Collaborates with IT and business units to advance the enterprise’s reporting capabilities and improve accuracy of data.
Payer Contract Reporting
- Develops and prepares payer scorecards & dashboards showing high level results and trends. Provides direct skills and leads a team of analysts in developing and preparing a consistent set of reports/dashboards for leadership that reflect established performance standards and metrics. Develops and executes internal contract performance reporting using internal data sets and payer supplied data.
- Maintains positive working relationships with and provides reporting & analytical support to business units and support cross-functional projects as needed. Participates in payer discussions and effectively represents subject expertise.
- Leads an effective communication strategy of data and analytics to internal and external stakeholders. Provides effective and timely communication on workload prioritization and progress to all appropriate parties.
- Hires, trains, manages, mentors and develops a high performing team that effectively implements contract strategy that is integrated and aligned with enterprise goals. Develops staff to enhance technical skills and expand knowledge of systems, methods, practices, and procedural guidelines. Initiates projects and oversees day-to-day activities involving multiple internal and external team members as needed. Contributes to a learning and growth culture.
- Performs miscellaneous job related duties as requested.