Experienced Long-Term Care (LTC) Rate Setting Analyst

Summary

As a Experienced Long-Term Care (LTC) Rate Setting Analyst at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. You will be responsible for manipulating and analyzing large datasets to produce actionable insights into program operations. Your day-to-day work will involve running queries with data warehouse software, researching reimbursement methodologies, collaborating with stakeholders, and developing models for reimbursing Medicaid providers. For this fully remote position the candidate must reside in the continental US.  Here are the details on this position.

Your role in our mission

Play a critical part in ensuring Gainwell is meeting our clients’ objectives in important areas.

As the Long-Term Care Rate Setting Analyst you will have lead responsibilities in the areas of rate setting, cost analysis planning, research, development and implementation of policies designed to encourage cost efficiency and promote program and departmental objectives in a large and complex health care program. These complex responsibilities entail the use of advanced budgeting and statistical concepts; program policy, planning, and development techniques. You will be responsible for manipulating and analyzing large datasets to produce actionable insights into program operations. Your day-to-day work will involve running queries with data warehouse software, researching reimbursement methodologies, collaborating with stakeholders, and developing models for reimbursing Medicaid providers. Applicants need strong technical skills in Excel and/or statistical software, or a demonstrated ability to learn similar software. Applicants also need excellent communication skills and teamwork to understand the question to be addressed by data requests, identify an analytical approach to answer that question, and communicate findings to internal stakeholders.

In addition, you will provide analytical support for the development and implementation of fee for service or capitated rate setting methods for contracted Managed Care Organizations and for monitoring and analyzing the accuracy and sufficiency of rates generated by the rate-setting models for contracting organizations.

In addition to the technical work described above, you will also monitor changes to State and Federal rules as well as Managed Care program policies and best practices that may affect costs, pricing, or program operational issues and assisting in the design of appropriate modifications to rate setting strategies. You will work with external business partners in order to support program improvement and the transparency of rate-setting methods, policy, and data systems.

What we're looking for

Minimally qualified applicants will have all of the following:

• Experience analyzing, developing, or reviewing government, business or health care policies that can impact multiple internal or external partners (i.e., individuals, business, and organizations).
• Experience using software such as Excel, STATA, SAS, SPSS, R, or similar to perform data analysis, extraction, and manipulation.
• Experience writing and presenting papers, reports, articles, or similar on topics related to data, policy, or economic analysis.

Well-qualified applicants will also have one or more of the following:

• Experience or education in public policy, statistics or economics.
• Experience working with Medicaid programs or information systems.
• Experience working independently, tracking timelines, planning and coordinating work for projects, etc.

What you should expect in this role

• Fully remote opportunity from the continental US
• Video cameras must be used during all interviews, as well as during the initial week of orientation

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