MgrContract Analytics&Control in Secaucus, NJ at Quest Diagnostics

Date Posted: 7/22/2021

Job Snapshot

Job Description

Sr. Manager Contract Analytics & Control - Health Plan Finance - Secaucus NJ 

Look for more than answers. Patients and Physicians rely on our diagnostic testing, information and services to help them make better healthcare decisions. These are often serious decisions with far reaching consequences, and require sensitivity, tact and a clear dedication to service. It’s about providing clarity and hope. 

You will work for the world leader in the industry, with a career where you can expand your skills and knowledge. You’ll have a role where you can act with professionalism, you can inspire colleagues, and you can care about the work we do and the people we serve. 

At Quest, we are on a continuous journey of discovery and development. It’s this attitude that has made us an industry leader and the #1 Diagnostic Lab in the US. For those joining us, we offer exciting and fast moving career opportunities where you can affect change at a rate unheard of in many organizations of our size and scope. While we invest in and develop technology to drive our innovations, our ongoing success relies on our people.

Position Description:

The Senior Manager, Contract Analytics & Control reports directly to the Sr. Director, Health Plan Finance.  S/He is responsible for various reporting and analyses, the Sales Incentive Plan process for the Health Plan Sales Team, QuestNet, management of the Health Plan Finance controls environment and numerous ad hoc analyses supporting growth of the Company. 

Responsibilities:

•         Controls

o   Liaison with Commercial Contracting for all health plan agreement related controls ensuring compliance with Authorization Matrix

o   Owner of Health Plan Finance SOX Controls

o   Owns relationship with Internal Audit for controls reporting

o   Owns review and system management of Approval Request Documents (ARDs) for approval processing

•         Contract Analytics

o   Contract Renewals and expirations – monthly compilation and review of contract status (risk and opportunities for the Company)

o   Fee schedule maintenance – owns project to link reporting information to fee schedules; centralize fee schedules into singular repository for accuracy and control

o   Liaison with Optum for 3pf mapping issues, questions, and fee schedule related questions (3pf mapping process required for accurate reporting)

o   Support and facilitate fee schedule details to required parties for audits and / or reimbursement reviews

•         Sales Compensation for Health Plan Sales Team

o   Owns Sales Compensation process for Health Plan Sales team (Sales Incentive Plan) – includes monthly, quarterly and annual processing and analyses

o   Liaison with RR&A for related mapping changes and sales comp settlements

•         Ad Hoc Analyses

o   Liaise with Regional Finance, Compliance, Clinical Franchises, Medical Coding, Billing, Legal for clinical franchise pricing updates (Impact analyses)

o   Special projects to support pricing analytics or system enhancements

•         QuestNet

o   Owns QuestNet process which includes analyses and processing of monthly provider payments and client relationships

o   Liaison with legal for QuestNet provider contracting

•         Supervisor to 3 senior financial analysts

o   Responsible for the daily management and development of SFAs

 

Qualifications:

•         Bachelor’s Degree in Finance or Analytical Field

•         7+ years of experience in finance, accounting (controls) or highly analytical field

•         Direct supervisory experience strongly preferred

•         Highly self-motivated to “make a difference” and act as a change agent

•         Comfortable working in a matrix organization with cross-functional teams with no direct reporting relationship

•         Demonstrates skill in working with senior management and functional subject matter experts

•         Capable of deploying and articulating strategic solutions to prospective business challenges

•         Demonstrates a strong knowledge of operational and financial processes and practical application of financial and strategic analysis

•         Excellent process and project management skills

•         Strong MS Excel, database and Essbase / PeopleSoft experience desired

Competencies Critical for Success in the Role:

•         Process management and priority setting

•         Business partnership

•         Business acumen & Strategic thinking

•         Analytical Skills

•         Drive for Results

•         Excellent communication skills

•         Prior experience making formal and informal presentations to senior management a plus

•         Excellent problem solving and financial modeling capabilities

•         Ability to delegate, motivate, and provide thought leadership and direction to teams

•         Collaborative skills

•         Strong leadership & professional presence

•         Strong ownership and accountability

•         High energy, pro-active change agent