Senior Financial Analyst, remote
Mass General Brigham Health Plan

Somerville, Massachusetts

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.

Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated.

We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more.

The Senior Financial Analyst provides value-added analytic support to Provider Network Management (PNM) in meeting Mass General Brigham Health Plan's strategic objectives. S/he must have extensive experience working with Medicare claims data. S/he possesses in-depth knowledge of contracting and risk-sharing models and regulatory issues governing payments to providers in a Medicare Advantage setting. S/he independently designs and performs analyses to measure the financial impact of provider contracts and reimbursement changes. In addition, s/he effectively partners with Finance and PNM staff and managers in support of specific contract negotiations as well as broader network-wide payment models.

Essential Functions
• Works collaboratively with PNM staff and managers in support of contract negotiation and other provider payment changes:
o Functions as the subject matter expert regarding Medicare reimbursement methodologies
o Researches guidelines, requirements, and changes to Medicare reimbursement methodologies
o Gathers and analyzes information from multiple sources to develop a "profile" of provider/facility facilitating a more robust contracting conversation
o Identifies opportunities for improved savings and payment models to better align provider incentives
o Translates business objectives into data queries and analytic models
o Actively participates in strategy discussions with PNM and finance colleagues in discussions regarding the overall direction and objectives for specific contracts
o Effectively interprets data and communicates findings/recommendations both orally and in writing appropriate to the audience
o Actively participates in external provider contract meetings with PNM colleagues
• Designs and executes complex data queries and analyses to evaluate the impact of proposed and actual contractual changes
• Models various scenarios to assist PNM staff in understanding options in contracting models
• Develops ongoing means to monitor the financial/cost impact of new and existing contracts and other payment changes, including global payment and risk-sharing arrangements
• Proactively identifies opportunities to improve Mass General Brigham Health Plan's financial position through enhanced payment arrangements
• Work collaboratively with the Actuarial Team in support of ongoing Trend Analysis.
o Design and execute queries to identify drivers of change in unit cost
o Analyze data and quantify impact of unit cost on overall medical cost trend by category of care and by product/line of business
• Designs and executes queries and develops reports in support of state and federal regulatory requirements
• Collaborates with finance and budget staff in quantifying the impact of contract savings on overall medical expenses and trends
• Ensures the validity and accuracy of all data/information reported and presented
• Works collaboratively with IT to: enhance automation of processes; establish data warehouse standards and definitions; and to identify new tools to facilitate standard querying and reporting
• Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respect.
• Hold self and others accountable to meet commitments
• Ensure diversity, equity, and inclusion are integrated as a guiding principle
• Persist in accomplishing objectives, despite obstacles and setbacks, to consistently achieve results
• Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization
• Hold self and others accountable to meet commitments.
• Ensure diversity, equity, and inclusion are integrated as a guiding principle.
• Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise.
• Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization.
• Other duties as assigned with or without accommodation.

Working Conditions and Physical Effort
• Work is normally performed in a remote office work environment.

Minimum Requirements
Knowledge and Education

• Bachelor's Degree in related field
• Master's Degree in related field


• 4-6 years of Medicare analytic, IT, reimbursement, and/or contract configuration experience in healthcare
• 2-3 years prior experience working with Medicare Advantage claims data
• Prior experience working for a health plan or in a managed care setting


• Demonstrate Mass General Brigham Health Plan's core brand principles of always listening, challenging conventions, and providing value.
• Strong aptitude for technology-based solutions.
• Ability to inject energy, when and where it's needed.
• Respect the talent and unique contribution of every individual, and treat all people in a fair and equitable manner.
• Exercise self-awareness; monitor impact on others; be receptive to and seek out feedback; use self-discipline to adjust to feedback.
• Be accountable for delivering high-quality work. Act with a clear sense of ownership.
• Bring fresh ideas forward by actively listening to and working with employees and the people we serve.

The majority of work is conducted with minimal oversight or supervision. The Sr. Analyst independently designs and executes data queries, analyzes and interprets findings, and presents results to manager and director-level staff. When data appear out of the expected range, the Sr. Analyst independently investigates and presents findings to supervisor, as needed.

Organizational Relationships/Scope
The Senior Financial Analyst works collaboratively with staff, managers, and directors in Finance, Provider Network Management, and Clinical Services. In addition, the Sr. Analyst will interact with Mass General Brigham Health Plan Executives and externally, with individuals from our provider network.

EEO Statement
Mass General Brigham is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.


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