Here, it's different. Come join us.

Children's Hospital Colorado has defined and delivered pediatric healthcare excellence for more than 100 years.

Here, the nation's brightest nurses, physicians, scientists, researchers, therapists, and care providers are creating the future of child health. With an optimist's outlook, a trailblazing spirit, and a celebrated history, we're making new strides every day.

We've been Magnet-designated four times by the American Nurses Credentialing Center and are consistently recognized among the best of the best pediatric hospitals with #1 rankings in Colorado and the region by U.S. News & World Report.

As a national leader in pediatric care, we serve children and families from all over the nation. Our System of Care includes four pediatric hospitals, 11 specialty care centers, 1,300+ outreach clinics and more than 10,000 healthcare professionals representing the full spectrum of pediatric care specialties.

Here, we know it takes all of us, every role, to deliver the best possible care to each child and family we treat.

That's why we build our teams toward a foundation of equity in access, advancement, and opportunity. We know teams of individuals with different identities and backgrounds can nurture creativity and innovation. We know we can see, treat, and heal children better when our team reflects the diversity of our patient population. We strive to attract and retain diverse talent because we know a truly inclusive and equitable workforce will help us one day realize our most basic calling: to heal every child who comes through our doors.

A career at Children's Colorado will challenge you, inspire you, and motivate you to make a difference in the life of a child. Here, it's different.

The Payment Transformation / Managed Care Reimbursement and Analytics Manager is responsible for overseeing the technical and analytical support related to the evaluation, negotiation, implementation, maintenance and performance reporting of commercial and governmental payer contracts for CHCO across the organization. This position must be able to manage a highly-skilled team of financial analysts while supporting the development of new reimbursement/payment methodologies that are consistent with CHCO's strategic plan and recommending strategies for maximizing reimbursement and market share.

Department Name:Decision Support
Job Status: Full time, 40 hours per week
Shift: Monday to Friday 8am to 4:30pm- Hybrid

• EDUCATION - Bachelor's degree is required.

• EXPERIENCE - Minimum of five (5) years of healthcare and/or payer financial analysis experience. Supervisory experience preferred.

POPULATION SPECIFIC CARE

No direct patient care.

ESSENTIAL FUNCTIONS

An employee in this position may be called upon to do any or all of the following essential functions. These examples do not include all of the functions which the employee may be expected to perform.

1. Proven ability to negotiate complex reimbursement scenarios as an integral part of the negotiation team.
2. Build, manage and mentor a team responsible for gathering, analyzing, and presenting complex financial data related to hospital, provider and clinically integrated network (CIN) payer contracts.
3. Responsible for the design/implementation of complex data analysis processes to support Payer partnership initiatives, such as outcomes reporting, alternative payment models, and shared savings contracting.
4. Direct oversight of all financial models developed and utilized in payer contracting initiatives.
5. Manage the coordination, compilation and modeling of all analyses related to the financial/cost impact of new and existing fee-for-service and value-based care contracts and other alternative payment models, including global payment, risk-sharing arrangements, and funds flow models, utilizing complex spreadsheet and/or database applications.
6. Significant involvement in the hospital, physician, and CIN negotiations and implementation of reimbursement methodologies and associated language for all commercial and governmental payer contracting initiatives.
7. Oversee the development and on-going monitoring of contract financial performance reporting which includes the preparation and delivery of financial results to the CHCO and CIN executive teams.
8. Lead and manage all projects through the various complexities that arise in contract negotiations to completion under time-sensitive deadlines.
9. Keep up to date on trends and regulatory changes and requirements impacting the hospital and physician reimbursement.
10. Responsible for managing department financials.

SCOPE AND LEVEL

Guidelines: Guidelines are in the form of stated goals and objectives for function.

Complexity: Work assignment is unstructured and leader is responsible for implementing and managing a variety of objectives, resources, and initiatives to achieve the goals of the function. Duties performed include operational planning; developing standards, priorities, guidelines, processes, measurement (evaluation) systems; implementation of production and performance management standards; and allocating resources. Work is tactical and operational in nature.

Decision Making: Employee is responsible for planning, organizing, allocating resources, ensuring compliance with procedures, and achieving the objectives of the function.

Communications: Communication at this level is primarily internally focused and involves establishing and maintaining effective working relationships with team members, peers, directors, and executives. Provides guidance and interpretation of the enterprise's policies, procedures, and standards. Provides information to higher-level directors and executives.

Supervision Received: Responsible for achieving the objectives of function within the scope of established guidelines. Employee is expected to resolve problems that arise in the normal course of the work. Work is reviewed for soundness of judgment and feasibility of decisions.

Ability to Perform Essential Functions of the Job

It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. Be aware that none of the questions are intended to imply illegal preferences or discrimination based on non-job-related information.

Here, you matter. As a Children's Hospital Colorado team member, you will receive a competitive pay and benefits package designed to take care of your needs that includes base pay, incentives, paid time off, medical/dental/vision insurance, company provided life and disability insurance, paid parental leave, 403b employer match (retirement savings), a robust wellness program, and access to professional development tools, including an education benefit to help you advance your career.

As part of our Total Rewards package, Children's Colorado offers an annual employee bonus program that rewards eligible team members based on organizational performance. If organizational goals are met for the year, the bonus is paid out the following April.

Children's Colorado delivers annual base pay increases to eligible team members based on their performance over the previous year.