Senior Financial Analyst, Population Health Management

Site: Mass General Brigham Incorporated

 

At Mass General Brigham, we know it takes a surprising range of talented professionals to advance our mission—from doctors, nurses, business people and tech experts, to dedicated researchers and systems analysts. As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community.  We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve.

At Mass General Brigham, we believe a diverse set of backgrounds and lived experiences makes us stronger by challenging our assumptions with new perspectives that can drive revolutionary discoveries in medical innovations in research and patient care. Therefore, we invite and welcome applicants from traditionally underrepresented groups in healthcare — people of color, people with disabilities, LGBTQ community, and/or gender expansive, first and second-generation immigrants, veterans, and people from different socioeconomic backgrounds – to apply.

 

 

Job Summary

General Overview

The Population Health Management (PHM) department is charged with driving improved value for patients across Mass General Brigham. PHM leverages financial and clinical data to examine opportunities and design and deliver innovative care models. We value problem-solving, teamwork, and leadership skills to drive ongoing care delivery improvement for our patients. The Financial Planning team supports PHM leadership in analysis and projections in our value-based contracts with commercial and government payers. The team manages numerous funds flow decisions and consumes many data sources for analyzing the financial and provider data. A key component of the teams’ success is understanding the contractual risk share arrangements and maintaining relationships built with the Finance teams across the Mass General Brigham system.

The Sr. Financial Analyst is an integral member of the Population Health Services Organization (PHSO) Financial Planning team. This position will provide support for the PHSO budget, finance operations (including Internal Performance Framework revenue process and funds flow) and Medicaid ACO revenue/funding operations).

Principal Duties and Responsibilities

- Internal Performance Framework Revenue Process: Aggregate system-wide commercial revenue in relation to our commercial risk contracts to calculate financial incentive dollars at risk in the IPF. This process was created to satisfy financial integration regulatory requirements to translate contract incentive across the MGB network. This requires understanding of the complex internal performance framework logic and claims datasets. Responsibilities include claims analysis using pre-existing Microsoft Access workbooks and Excel workbooks, confirming RSO and provider assignment logic, auditing the revenue data for accuracy, and troubleshooting discrepancies on a quarterly basis. At final settlement, the Sr. Analyst would complete a final revenue assignment task that traces revenue to the provider by risk category. The analyst should be able communicate complex issues when they are identified to the Director of Network Risk and Provider Finance for further follow-up with the payers. Additional ad-hoc analytics related to IPF revenue reporting may be required.

- Medicaid ACO Membership Reporting: Produce a monthly suite of membership detail reports for internal PHSO use. This role would be responsible for summarizing the membership detail atthe practice level for our Medicaid ACO. Ensure accuracy of Explanation of Payment reports and detail. Translate details into deliverables that are timely, accurate, and value added.

- Medicaid Funding & Support Tracking: Track Medicaid ACO funding streams from MassHealth as well as other funding streams throughout the system to support our Medicaid operations within the PHSO. This will include monthly reconciliation of funding as well as assisting with the budget projections. Separately, this task also requires working in partnership with Mass General Brigham Health Plan to track and project pass-through funding from MassHealth. Support annual process (in collaboration with MGB Health Plan) to evaluate new performance year MassHealth rates and communicate rates and rate impact to our provider network.

- Budgeting Process: Provide support during Population Health Services Organization enterprise budgeting process. During this process, the Sr. Analyst will provide direct support to the PHSO Budget & Finance Manager to manage the master Excel budget workbook, meet with budget owners, and provide various financial analysis to support budget requests. This role should be able to take direction and seek information from stakeholders as needed. This process req