At Cincinnati Children’s, we come to work with one goal: to make children’s health better. We believe in a holistic team approach, both in caring for patients and their families, and in advancing science and discovery. We strive to do better and find energy and inspiration in our shared purpose. If you want to be the best you can be, you can do it at Cincinnati Children’s.
Cincinnati Children's Hospital Has Been Named:
The #1 Pediatric Hospital in the Nation- US News and World Report 2023
One of four Medical Centers making the list of the 2022 Glassdoor Best Places to Work
An LGBTQ+ Healthcare Equality Top Performer in 2022 by The Human Rights Campaign (HRC)
Market Leading Benefits Including:
Medical coverage starting day 1 of employment. View employee benefits here: https://www.cincinnatichildrens.org/careers/benefits
Pension plan and optional 403(b) supplemental retirement plans
Tuition reimbursement for continuing education
Expansive employee discount programs through our many community partners
Referral bonus program for current staff!
Support through Employee Resource Groups such as African American Professionals Advisory Council, Asian Cultural and Professional Group, EQUAL - LGBTQIA Resource Group, Juntos - Hispanic/Latin Resource Group, Veterans and Military Family Advocacy Network, and Young Professionals (YP) Resource Group
Physical and mental health wellness programs
SUBFUNCTION DEFINITION: Support the enterprise in evaluating and responding to policies impacting reimbursement from Medicare, Medicaid, TRICARE, and other government payor. This includes hospital and professional finances, and any contracting and/or other government payor related issue impacting our reimbursement. This individual will serve as the point person for innovation applications related to Medicaid, inclusive of mainly Ohio, Kentucky, and Indiana. This individual will identify and track major trends and developments in publicly-financed pediatric care and develop financial models to understand the enterprise impact as well as impact to patients.
CAREER LEVEL SUMMARY: Requires full proficiency through job related training and considerable on-the-job experience to perform range of tasks. Works under limited supervision for routine situations. Non-routine problems are solved by applying precedents and existing processes to new situations. Identifies key issues and patterns from partial/conflicting data. May act as an informal resource for colleague with less experience.
Medicaid Policy Trending and Reimbursement Impact - Lead work in conceptualizing, specifying and testing financial models to assess potential financial impacts of government reimbursement (mainly Medicaid) programs and contracts; Identify and track major trends and developments in publicly-financed pediatric care and develop financial models to understand the enterprise impact as well as impact to patients. This is inclusive of impact of changes to various reimbursement methods including DRGs, EAPGs, and Ohio’s Franchise Fee program and Healthcare Assurance Program (HCAP).
Reporting – Develop, produce, monitor and analyze reports related to reimbursement from government payors, inclusive of Medicaid managed care organizations.
Healthcare Systems Analysis and Consultation - Analyze healthcare and hospital system data, government payor policies and contracts, utilize public and private data sets to inform decision making and strategy.
Business Planning and Strategy - Inform and support enterprise stakeholders regarding government payor policies and impact to the business.
Bachelor's degree in a related field
5 - 7 years of work experience in a related job discipline.
Experience with government entity and/or advocacy organization evaluating/implementing reimbursement policies
Strong Excel skills (PivotTables, vlookups, data modeling, etc)
Familiarity with SAP BusinessObjects
Previous analytics experience, ideally with healthcare reimbursement
Cincinnati Children's is proud to be an Equal Opportunity Employer that values and treasures Diversity, Equity, and Inclusion. We are committed to creating an environment of dignity and respect for all our employees, patients, and families (EEO/AA).
About Cincinnati Children's Hospital Medical Center - Cincinnati, OH
Cincinnati Children's is a nonprofit, comprehensive pediatric health system. As a leader in research and education, Cincinnati Children’s is consistently ranked as one of America's best children's hospitals by U.S. News & World Report and is one of the top recipients of pediatric research grants from the National Institutes of Health.