Sutter Health SMN Business Analyst in Sacramento, California

Description

Sutter Medical Network is a system of Sutter Health medical groups responsible for integrating aspects of the care delivery system in order to improve the quality, service, and affordability of health care services. Sutter Medical Network's purpose, working in partnership with the overall Sutter Health network, is to provide consistently superb and affordable healthcare – where, when and how patients want it. Sutter Medical Network is part of the Health Plan Products (HPP) which is Sutter's primary market engagement organization, responsible for ensuring that patients can access Sutter Health through a wide range of products.

The Sutter Medical Network, Business Analyst assists the Director and Sr. Analyst with network performance functions. This position works closely with the network staff to provide information necessary for the design, implementation and administration of provider payment methodologies and overall network performance that support network goals in addition to establishing standardization across contracts to support Sutter Health's business objectives. The Business Analyst may also work closely with other departments to assist with technical aspects of product performance, or assigned special projects. As assigned, the Business Analyst may provide consulting expertise to other departments within Sutter Health in order to deliver best practices from both a product and operations prospective.

Qualifications

Experience

• Previous experience working in a healthcare setting with a focus on healthcare analytics, as typically acquired during 5-7 years in a similar position

• Proven experience working with contract review and development

• Prior experience with capitation and risk sharing arrangements management

• Significant experience working with managed care contracting and negotiations

• Proven experience in managed care contracting, network contracting and management, network development or provider relations

• Previous experience in Medicaid/Medicare contracting and negotiating hospital, large physician groups and ancillary service agreements

Knowledge

• Thorough understanding of the Healthcare industry, including an understanding of Managed Care, Provider Organizations, claim and encounter processing, CPTs, ICD-9, RVUs, etc

• General knowledge of reporting tools such as Server Reporting Services (SQL), Crystal Reports, Business Objects and Cognos Impromptu

• Solid understanding of Windows operating systems and MS Office tools/applications, including Excel and related software tools and database concepts

• Solid understanding of healthcare network, contracting and claims payment processes and methodologies

• Extensive knowledge of contract interpretation and system configuration

Skills

• Excellent verbal and written communication skills needed to support technical development or software installation and support

• Proficient at specifying user requirements and/or acting as a liaison between users and developers

• Proven ability to maintain a high level of energy and creativity while working independently or as part of a team

• Demonstrated ability to articulate technical and customer needs in a concise and easily understood manner

• Proven ability to perform analyses such as GAP, process mapping, root-cause, risk, and requirements data gathering

• Demonstrated analytical, problem-solving and project management skills

• Strong documenting, planning and organizing skills to scope and manage multiple competing priorities

• Strong ability to influence and drive ideas, initiatives, goals, and quality decisions throughout the organization, including with teams, peers and leaders across the organization

• Demonstrated ability to identify and understand the contractual needs of the organization and prepare the analysis needed for leaders to make informed and effective business decisions

• Advanced level of proficiency with Microsoft Office products including, Access, Word, Power Point, and Business objects and Amisys

• Proven ability to meet strategic objectives, operating and business plans and time schedules

Education

  • Bachelors Degree in Mangement Information Systems, Computer Science, Healthcare Administration, Finance or related field or equivalent education/experience

  • Masters Degree in Business, Healthcare Administration, Finance or related field desired

Primary Location: California, Greater Sacramento Area, Sacramento

Organization: Sutter Health System Office

Employee Status: Regular

Benefits: Yes

Position Status: Exempt

Union: No

Job Shift: Day

Shift Hours: 8 Hour Shift

Days of the Week Scheduled: Monday-Friday

Weekend Requirements: Other

Schedule: Full Time

Hrs Per 2wk Pay Period: 80

All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a driver's license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.