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Payor Contracting Sr. Financial Analyst/Full Time/Hybrid

Henry Ford Health System
United States, Michigan, Troy
Aug 22, 2025

GENERAL SUMMARY:

Under supervision of Manager and / or Director, support the managed care contracting function by performing necessary financial analysis to evaluate payor (or health plan) contract performance and payor rate proposals during contract negotiations and throughout the contract year. This includes benchmarking to regional averages, comparing to Government fee schedules and analyzing existing healthcare (claims) data and reimbursement terms and payment methodologies; with the goal of driving necessary improvement in net revenue for the health system.

PRINCIPLE DUTIES AND RESPONSIBILITIES:

1. Perform deep dive financial analysis to develop and evaluate rate proposals and evaluate health plans financial performance.

2. Monitor contract specific payor rates and identify opportunities for improvement.

3. Review rate sections of proposed contracts and amendments to ascertain that all necessary reimbursement terms are included, and rates are depicted as negotiated.

4. Prepare plan level volume and profitability reports routinely and update as needed.

5. Assume active role in implementation and maintenance of contract management and pricing systems.

6. Develop "what if" scenarios and models in Excel to quickly assess margin impact of changing various reimbursement components.

7. Validate inpatient and high dollar outpatient payments for various payors, including MA, Medicaid and Commercial.

8. Create prospective and retrospective analyses to assess payment discrepancies or opportunities for revenue capture.

9. Develop queries and reports to extract claims and payor data from dbase reporting tool.

10.Perform other duties as assigned.

EDUCATION/EXPERIENCE REQUIRED:

  • Bachelor's Degree in Business, Accounting, Healthcare or related field.
  • Minimum of four (4) years in the Healthcare industry in Managed Care Contracting, Provider Relations, Provider Reimbursement or related professional capacity.
  • Excellent analytical skills.
  • Understanding of various product reimbursements (Medicaid, Medicare, Commercial).
  • Highly Proficient in Microsoft Excel: Pivots, formulas, modeling, graphs, etc.
  • Microsoft PowerPoint able to create or update PPT's. Skilled in EPSi , SQL, Clarity or other Data query reporting tools.
  • 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.
  • Familiarity with Healthcare EHR / Claim Systems (i.e. EPIC or similar), preferred.
  • Understanding of legal, business, and insurance operations principles.
Additional Information


  • Organization: Corporate Services
  • Department: Managed Care Contracting
  • Shift: Day Job
  • Union Code: Not Applicable

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