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You’ll want to join Billings Clinic for our outstanding quality of care, exciting environment, interesting cases from a vast geography, advanced technology and educational opportunities. We are in the top 1% of hospitals internationally for receiving Magnet® Recognition consecutively since 2006.

And you’ll want to stay at Billings Clinic for the amazing teamwork, caring atmosphere, and a culture that values kindness, safety and courage. This is an incredible place to learn and grow. Billings, Montana, is a friendly, college community in the Rocky Mountains with great schools and abundant family activities. Amazing outdoor recreation is just minutes from home. Four seasons of sunshine!

You can make a difference here.

About Us

Billings Clinic is a community-owned, not-for-profit, Physician-led health system based in Billings with more than 4,700 employees, including over 550 physicians and non-physician providers. Our integrated organization consists of a multi-specialty group practice and a 304-bed hospital.Learn more (https://www.billingsclinic.com/about-us/) about Billings Clinic (our organization, history, mission, leadership and regional locations) and how we are recognized nationally for our exceptional quality.

Your Benefits

We provide a comprehensive and competitive benefits package to all full- and part-time employees (minimum of 20 hours/week), including Medical, Dental, Vision, 403(b) Retirement Plan with employer matching, Defined Contribution Pension Plan, Paid Time Off, employee wellness program, and much more.Click here (https://www.billingsclinic.com/careers/employee-benefits/) for more information ordownload the Employee Benefits Guide (https://ncstoragemlbillings.blob.core.windows.net/public/2021%20Billings%20Clinic%20Staff%20Benefits%20Guide.pdf) .

Magnet: Commitment to Nursing Excellence

Billings Clinic is proud to be recognized for nursing excellence as a Magnet®-designated organization, joining only 97 other organizations worldwide that have achieved this honor four times. The re-designation process happens every four years. Click here (https://www.billingsclinic.com/campaign-landing-pages/magnet/) to learn more!

Pre-Employment Requirements

All new employees must complete several pre-employment requirements prior to starting. Click here (https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more!

Payer Relations Analyst (1.0)

PAYER RELATIONS (BILLINGS CLINIC HOSPITAL)

req9805

Shift: Day

Employment Status: Full-Time (.75 or greater)

Hours per Pay Period: 1.00 = 80 hours every two weeks (Exempt)

Starting Wage DOE: $32.06 - 40.07

The Payer Relations Analyst is required to work independently with minimal supervision and on teams, to support all analytical aspects of Payer Relations strategy, planning and implementation. The Analyst provides comprehensive modeling analysis for the evaluation and negotiation of new and existing contracts with commercial and government payers for all Billings Clinic facilities, physicians, providers, locations and applicable controlled entities. Responsibilities include production and analysis of accurate financial projections and modeled reimbursement outcomes for a complex array of contract terms and reimbursement methodologies including fee-for-service, value-based, episode bundling, shared savings/risk and capitated methodologies, using a variety of tools and data sources. Role includes programming payer contract and reimbursement terms into contract management system, projecting operational impact of contract terms, producing and analyzing payer data to evaluate payer compliance and performance, and other analysis, preparing and presenting credible payer financial information to Billings Clinic leadership, management, staff and external stakeholders including payers, and developing payer report cards. This position requires a thorough understanding of medical economics, health care financing, evolving reimbursement methodologies, benefit plan design, and the revenue cycle process.

Essential Job Functions

• Supports and models behaviors consistent with Billings Clinic’s mission, vision, values, code of business conduct and service expectations. Meets all mandatory organizational and departmental requirements. Maintains competency in all organizational, departmental and outside agency standards as it relates to the environment, employee, patient safety or job performance.

• Supports all payer contract negotiations through development of sophisticated contract modeling and contract performance reporting and analysis using multiple tools and databases as necessary. Assists contract negotiation team and Senior Leadership in reviewing and analyzing contract proposals for financial impact to the organization, and provides input regarding ease of administration of proposed terms. Conducts ad-hoc data requests.

• Acts as Billings Clinic’s key resource for the management and maintenance of all commercial and other negotiated payer contract terms in contract management system(s). Responsible for the data integrity of data processing/reporting generated from the system(s). Responsible for working with these systems to ensure compliance via interpretation, analysis, and modeling of contracts. Uses in-depth knowledge of reimbursement regulations in a complex health care environment to encode or program contract terms within each system.

• Produces an accurate and comprehensive cumulative database of payer volume, financial and demographic information on at least a quarterly basis or more frequently if needed, to be utilized for payer analysis activities, identified to the detailed employer and plan level.

• Serves as a subject matter expert for leadership, department management, and other staff regarding the inter-relationships of data with respect to payers, employers, contract relationships, and complex and evolving fee-for-service and value-based reimbursement methodologies.

• Responsible to use tools and methods to research and investigate any issues with contract implementation or on-going contract compliance or performance and develops reports and summaries, as appropriate, to outline issue and proposed solution for discussion with Billings Clinic leadership team. Responsible to resolve issues directly with internal departments and payers, and escalates issues as necessary to complete resolution. Maintains documentation of all account follow-up activities, as well as documentation on overall reimbursement issues. Provides summaries and reports as requested. Develops and maintain payer report cards.

• Researches national, regional and local market payer reimbursement trends and determines the potential impact to Billings Clinic revenue and/or market position.

• Participates in and/or leads and facilitates teams and committees as appropriate.

• Prepares and conducts formal and informal presentations regarding payer information in a clear, concise and informative manner to both internal and external groups, as required, using effective communication skills. Required to interpret data and make supporting recommendations based on findings.

• Takes proactive approach to identifying problems and opportunities and recommending solutions that support the strategic direction of the department or the organization.

• Utilizes performance improvement principles to assess departmental or organizational gaps in performance and identifies ways to improve quality and reduce waste.

• Identifies needs and sets goals for own growth and development; meets all mandatory organizational and departmental requirements.

• Maintains competency in all organizational, departmental and outside agency environmental, employee or patient safety standards relevant to job performance.

• Performs other duties as assigned or needed to meet the needs of the department/organization.

Minimum Qualifications

Education

• 4 Year / Bachelors Degree business, accounting, financial management, mathematics, statistics or related field

Experience

• 5 years of progressively responsible professional experience work experience with an emphasis on financial analysis

Or an equivalent combination of education and experience relating to the above tasks, knowledge, skills and abilities will be considered. Employees that require a licensed or certification must be properly licensed/certified and the licensure/certification must be in good standing.

Billings Clinic is Montana’s largest health system serving Montana, Wyoming and the western Dakotas. A not-for-profit organization led by a physician CEO, the health system is governed by a board of community members, nurses and physicians. Billings Clinic includes an integrated multi-specialty group practice, tertiary care hospital and trauma center, based in Billings, Montana. Learn more atwww.billingsclinic.com/aboutus (https://www.billingsclinic.com/about-us/)

Billings Clinic is committed to being an inclusive and welcoming employer, that strives to be kind, safe, and courageous in all we do. As an equal opportunity employer, our policies and processes are designed to achieve fair and equitable treatment of all employees and job applicants. All employees and job applicants will be provided the same treatment in all aspects of the employment relationship, regardless of race, color, religion, sex, gender identity, sexual orientation, pregnancy, marital status, national origin, age, genetic information, military status, and/or disability. To ensure we provide an accessible candidate experience for prospective employees, please let us know if you need any accommodations during the recruitment process.