AVP Analytics Data Management and Payment Integrity

Autism Care Partners (ACP) is a rapidly growing multi-state behavioral care organization supporting 

children (and families of children) impacted by autism spectrum disorder (ASD) and other 

developmental disabilities.

The AVP of Analytics, Data Management, & Payment Integrity’s primary focus will be on development of strategic 

analytics/reporting initiatives, information systems management and optimization, alternative payment 

model development, and ensuring the integrity/accuracy of payment collections and reporting. The role

will engage cross-functionally with ACP’s executive leadership team, departments across the 

organization, externally with payors/health systems, and intermittently with ACP’s investment 

colleagues at Coppermine Capital.

Essential Functions

• Analytics: Develop, maintain, and expand industry leading and enterprise level analytics and reporting suite, incorporating various data sources and data visualizations to support operations across all departments, including clinical operations, people operations, payor relations, finance, early intervention, etc.
• Analytics: Oversee and execute on creation, maintenance, and refinement of monthly and quarterly performance reporting on enterprise financial performance and growth for stakeholders, including ACP leadership, ACP senior leadership, Coppermine Capital, and the Board of Directors
• Data Mgmt.: Oversee maintenance and optimization of information systems (including practice management platforms) to ensure data integrity and utility for reporting and analytics; responsibilities include regular updates and audits on payor nomenclature, fee schedule, and provider configurations across all service types, among other key areas requiring regular updating and monitoring; 
• Data Mgmt.: Develop and implement information systems strategies that align with ACP’s objectives across business lines, including evaluating new technologies and optimizing existing systems
• Payment Integrity: Develop and implement payment integrity strategy (across all clinical service lines), including ongoing monitoring/maintenance/housing of fee schedule accuracy, timely billing and claims follow up (including spot audits), denial trends, copay collections, and over/underpayments, ultimately contributing to industry leading collections rate AVP Analytics, Data Management & Payment Integrity
• Payment Integrity: Produce both ad hoc and regular updates across key departmental leaders, spotlighting best practices and/or risk areas based on consistent and standardized trend analyses (payment trends, specific payor issues, collections, clinical utilization, personnel trends, etc.); will include a structured quarterly executive report highlighting key trends / risks
• Payment Integrity: Produce financial modeling to evaluate health plan rates across markets, identify areas of opportunity, and initiate and execute on regular rate negotiations to ensure ACP continues to achieve market leading rate reimbursement competitiveness

Competencies 

• Strong verbal and written communication skills
• Ability to translate reporting needs of clinical and operational terms to technical solutions based on available data, data structures, and analytics tool functionality
• Ability to work independently in a fast-paced environment managing multiple project deliverables and priorities
• Strong attention to detail
• Strong problem solving and decision-making skills
• Ability to think creatively to tailor communication and visualization of data based on stakeholder needs
• Comprehensive understanding of healthcare systems, health insurance, and behavioral health programs

Meeting Expectations

• Weekly 1:1s with supervisor
• • Regular meetings with regional and department leads (clinical, ops, finance, and early intervention)
• Biweekly development team meetings
• Quarterly with ACP’s Senior Leadership Team

Supervisory Responsibilities

• Oversight of analysts, system managers, and interns as needed

Work Environment

• This position operates in a remote environment.
• Travel Required
• Attendance of occasional in-person meetings and events across our centers in the Northeast required
• Periodic in-person meetings with NY based finance team for payment integrity review meetings

Education and Experience

• Education: BA/BS required in data science, data analytics, healthcare administration, or related field, master’s degree preferred
• 7+ years of demonstrated experience owning and executing critical initiatives 
• 7+ years of experienc