Business Information Consultant Senior - Provider Economics

Position Overview

The Business Information Consultant Senior is responsible for value-based financial model methodology development, financial model design, and forecasting the impact of provider payment models for all lines of business. This position serves as an expert in data analysis, reporting, and formulating recommendations. The role involves valuing new medical cost initiatives, applying financial modeling expertise, and using independent judgment to determine the best methods and approaches for calculating accurate estimates of program savings.

NOTE: This position is not eligible for current or future visa sponsorship.

Employment Type

Full-time

Anticipated End Date

2025-07-11

Location

• Preferred Locations: Richmond, VA; Woburn, MA; Atlanta, GA; Indianapolis, IN; Cincinnati, OH
• Location Type: Hybrid (1-2 days in-office per week)
• Note: Alternate locations may be considered.

Responsibilities

• Establishes, improves, and optimizes the consolidating processes for forecast and month-end results.
• Serves as an analyst and advisor to both internal and external stakeholders, developing value-based payment models and forecasting/measuring the value of Specialty Payment Models.
• Develops financial models for value-based programs.
• Understands the operational and technical components of value-based contracts and the systems in which they are run to explain to the market.
• Provides analytical support for strategic initiatives, such as contract negotiations, provider network optimization, and total cost of care management.
• Thoroughly vets and performs due diligence on potential value-based arrangements to assess financial impact, ensure operational feasibility, and identify impact on existing programs.
• Conducts comprehensive analysis of healthcare data, claims, and financial reports to identify trends, patterns, and opportunities for improvement.
• Consolidates and prepares executive summary reports for various business segments for top management decision-making.
• Analyzes and designs solutions to address varied and highly complex business needs.
• May collaborate with businesses and technical areas to implement new or enhanced products.
• May require strong knowledge of products, internal business models, and data systems.
• May coordinate with external audits as appropriate.
• Acts as the central contact with internal departments and external auditors.

Minimum Requirements

• Education: BA/BS degree in Statistics, Economics, or Business Administration.
• Experience: Minimum of 8 years of relevant experience, or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities, & Experiences

• Knowledge of IM technologies, organizational structure, and customer information needs.
• Prior leadership or management experience.
• Effective communication skills, including facilitation, consultation, negotiation, and persuasion.
• Deep knowledge of value-based care and/or population health management.
• Progressive experience leading and performing analytical work within the healthcare industry (e.g., health plans, large physician practices, hospitals, ancillary, medical facilities, healthcare vendors).
• Experienced with SAS, SQL, or similar data manipulation tools, including creating efficient and transparent queries, pulling large data sets, and performing data manipulations/analysis.
• Skilled at using data to tell financial stories with recommendations on how to create PMPM efficiencies and reduce cost.
• Self-motivated and creative.