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Finance Program Manager (Performance Analytics)
- New York, New York, United States
- New York, New York, United States
About
Job Summary The Population Health Finance Program Manager for Performance Analytics leads analysis on Population Health data sets and programs. This role focuses on program financial performance at a ACO, TIN and NPI level to include MSSP (Medicare Shared Savings Program) and Medicare Advantage. This role works with the external actuarial consulting team, other vendors, internal finance, IT/analytics, and brings strong knowledge of healthcare data sets.
The role requires experience working in health insurance, value-based care contracting, Accountable Care Organizations (ACOs), Clinically Integrated Networks (CINs), and other risk-based health care delivery due to the complexity and knowledge level required for success. It requires prior experience working in Medicare CCLFs and building out custom analyses in Excel and other tools.
The role supports forecasting and scenario modeling, and ensures the accuracy and integrity of financial datasets. The role translates actuarial and management guidance into financial forecasting across the entities to optimally grow PH operating performance while remaining compliant with appropriate financial and operating BSMH controls.
Essential Job Functions
Evaluates and translates performance in full risk arrangements, including Medicare and Medicare Advantage programs, into financial guidance; tracks performance under all value-based arrangements attributed to PH, bundled payment and shared savings program methodologies.
Analyze claims, eligibility, and contractual data from CMS and Payers to identify financial trends, risks, and opportunities.
Studies statistical data to create an analysis; estimates of probability, benchmarks and likely costs for a segment or population.
Uses PH tools, claims and eligibility and attribution data and other reporting systems and sources to provide clinical, financial, utilization, and claims analytics.
Develops trend analysis reports that monitor key performance indicators and compares them to internal and external benchmarks; uses this data to assist leadership in decision‑making, planning and implementing performance improvement strategies.
Sets targets by TINs, providers, markets, and reports against target vs. actual performance, working with our ACO/CIN network team.
Serves as a hands‑on analyst to review workflows and documentation.
Perform routine audits and analytics for existing value‑based programs to validate attribution, quality performance and financial reconciliations; monitors internal controls and makes recommendations for improvements, including coordinating across BSMH Internal Audit, third‑parties, other internal stakeholders.
Ensure HIPAA compliance, adherence to data governance standards, and protection of PHI.
Provide ad hoc analyses to support financial planning, vendor performance reviews, and strategic initiatives.
This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job‑related duties as required by their supervisor, subject to reasonable accommodation.
Education Bachelor’s degree in Health Informatics, Data Analytics, Accounting, or related field (required)
Master’s degree in Business Administration, Finance, Health Informatics, or related discipline (preferred)
Work Experience
5-10 years in healthcare finance/accounting and analytics
Proficiency in SQL, Tableau, Excel, and familiarity with relational database
Specific Knowledge and Experience Working in
Medicare CCLFs and Payer Claims files
Working in Milliman Medinsight and/or other claims‑based data warehouses
Working in Epic (preferred, not required) data with IT support
For MSSP, experience with
CCLF summary analysis
Claims analysis
BDCA early insights indicators
TIN and NPI level performance
For MA, experience with
Payer claims analysis
Reconciliation report analysis
Star Rating forecasting and analysis
TIN and NPI level performance
Hard/Tech/Clinical Skills
Healthcare finance and accounting know‑how
SQL querying and data extraction
Claims and eligibility data analysis
Tableau or equivalent data visualization tool
Financial modeling and forecasting
KPI development and monitoring
Relational database navigation and query optimization
Excel (advanced formulas, pivot tables, lookups)
HIPAA compliance and PHI protection practices
Data validation and audit preparation
Healthcare performance metric analysis (cost, utilization, quality)
Soft/Interpersonal Skills
Critical thinking and analytical reasoning
Clear and concise communication
Attention to detail and accuracy
Time management and meeting deadlines
Collaboration and team‑based problem solving
Translating data into actionable recommendations
Adaptability to evolving priorities
Stakeholder engagement and relationship building
Initiative and self‑motivation
Integrity and accountability in data handling
What we offer
Competitive pay, incentives, referral bonuses and 403(b) with employer contributions (when eligible)
Medical, dental, vision, prescription coverage, HSA/FSA options, life insurance, mental health resources and discounts
Paid time off, parental and FMLA leave, short‑ and long‑term disability, backup care for children and elders
Tuition assistance, professional development and continuing education support
Benefits may vary based on the market and employment status.
All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you'd like to view a copy of the affirmative action plan or policy statement for Bon Secours Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affiliated Action and Equal Opportunity Employers, please email recruitment@mercy.com . If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at recruitment@mercy.com
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Languages
- English
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