Healthcare Payment and Financing Analyst

With grant funds from the Centers for Disease Control and Prevention (CDC), DOHMH is undertaking a new initiative that will meet critical infrastructure needs and make possible strategic investments that will have lasting effects on public health. Investments and improvements through this initiative will help modernize DOHMH’s foundational capabilities and data infrastructure, enabling it to partner in complex health and health care environments and, in turn, support better public health outcomes, including COVID-19. This initiative supports larger efforts to rebalance investments in public health and more equitably serve communities and populations.

The selected candidate will be an employee of Public Health Solutions, a nonprofit organization which is the fiscal and administrative manager of the grant but will work be supervised by DOHMH.  This is a grant-funded position ending in November 2027.

The Center for Health Equity & Community Wellness (CHECW) seeks to eliminate racial and other inequities resulting in premature mortality. With an unwavering grounding in history and structural analysis, CHECW works to increase visibility of the harm perpetuated by centuries of racist, socially unjust policy while pushing towards redress for the most impacted NYC communities. CHECW addresses inequity across community and healthcare systems in partnership with community, faith-based, and health care organizations. CHECW’s work focuses on social determinants of health, including environmental and commercial determinants, and addresses both upstream and downstream factors to improve health and well-being of New Yorkers. CHECW is comprised of the Bureau of Bronx Neighborhood Health, the Bureau of Brooklyn Neighborhood Health, the Bureau of Harlem Neighborhood Health, the Bureau of Chronic Disease Prevention, the Bureau of Health Equity Capacity Building, the Bureau of Equitable Health Systems and the Bureau of Finance, Administration, and Services. The division’s Deputy Commissioner also serves as the Agency’s Chief Medical Officer.

The Bureau of Equitable Health Systems (BEHS) in the Center for Health Equity and Community Wellness (CHECW) for the New York City Department of Health and Mental Hygiene (DOHMH) consists of a multi-disciplinary team that aims to engage primary care providers, hospitals, and other healthcare systems to implement evidence-based strategies; leverage information to support planning and technical assistance for providers and payers; advance policy to close the racial equity gap for priority health outcomes; and surface opportunities where health care can influence and connect individuals to social support and address the whole person, beyond physical ailments.  The mortality experienced due to COVID-19 made visible the inequities that low-income patients experience in accessing the healthcare system, as well as the marginalization of essential healthcare workers. As we move forward towards an equitable COVID-19 recovery, we need to develop innovative solutions to improve the performance, equity, and efficiency of the healthcare delivery system.

Job description:

In this context, BEHS is looking to recruit an analyst to perform a variety of policy analyses of the financial incentives and payment innovations necessary to improve equity in healthcare access, outcomes, and eliminate de-facto segregation of care. General areas of work include but are not limited to:  

1. Provider payment and financing strategies for addressing care segregation and achieving health equity
2. Implementation of the upcoming New York State 1115 Medicaid waiver with a racial equity focus and promoting place-based interventions 
3. Development and implementation of a Maternal Home Collaborative, a payment model to address maternal mortality and morbidity
4. Support for community and social services organizations to expand into a social care delivery system for Medicaid in a way that is easy-to-access for patients and providers, and financially sustainable.
5. Facilitate inclusion of preventive and social care services into value-based and capitated arrangements, inclusive of through blending and braiding approaches to social care. 

 Duties:

1. Healthcare Payment and Financing:

• Investigate various healthcare payment and financing topics including but not limited to Medicaid/Medicare payment and credentialing, alternative payment models, value-based arrangements, and disproportionate share payments.
• Perform literature reviews of the impact of payment and financial policy changes and innovation nationally in quality and population health outcomes.
• Creates payment and finance policy goals. This includes but is not limited to preparing projected analyses on claims and utilization, including underlying trends and risk analyses to assist in planning for partner-led population health interventions. 

1. Policy Planning, Development, Implementation, & Analyses:

• Lead policy analyses of healthcare payment and financing initiatives, policies, and legislation
• Prepare briefs, reports, and presentations
• Leads program development and implementation for healthcare payment and financing initiatives
• Leads, facilitates, and coordinates meetings with stakeholders including but not limited to scheduling, preparing presentations, taking notes, and providing follow-up to action items. 
• Participates as Office of Healthcare System Strategy and Accountability (OHSSA) representative in workgroup(s)

1. Whole-person care:
   • Collaborate with stakeholders to identify key segments of the population, providers, services etc. to target for high value interventions.
   • Support the creation of a unified and operationally feasible vision for delivery of health-related-social-needs services so it maximizes impact on population health outcomes.
   • Work with payers, providers, and community-based organizations to co-create win-win payment models for health equity innovations; including blended and braided funding. 
2. Training
   1. Develop payment and financial analysis skills among policy and data analysts
3. Other
   1. Provide analysis of the unintended financial implications of policy and programs of interest for the health department. 
   2. Investigate innovations in healthcare delivery and financing nationally and assess appropriateness and feasibility of implementation in New York.
   3. Additional duties, as assigned

Qualifications:

• Advanced degree (masters, MD, PhD, DrPH, JD) in business, public health, health policy & management, healthcare finance, economics, or similar
• 3+ years of experience in roles that provide in-depth understanding of financial incentives in the healthcare delivery and payment systems
• 3-5 years experience in progressively complex healthcare policy analyses
• 3+ years of experience analyzing Medicaid and/or Medicare Federal/State regulation. 
• Experience doing research or analysis of healthcare policy
• Experience in policy and program planning, development, and implementation
• Experience producing briefs, memos, and reports 
• Rapidly able to self-teach software products
• Highly analytical and detailed oriented
• Understanding of health care performance metrics and key operating indicators
• Knowledge of statistical and financial metrics in a health care environment such as payor mix
• Health Insurance experience and proficiency in understanding professional and facility claims and managed care concepts such as risk adjustment, capitation, FFS, DRG, APG, APCs and other payment mechanisms
• Some experience in social service or community-based organizations, preferably related to contracting with government and/or insurance companies. 
• Effective communication and ability to translate financial information to non-financial customers (internal and external)
• Strong ability to handle multiple projects including problem solving, research, analysis, and communication in a fast-paced environment
• Salary - $97,000 - $97,000

Additional Desired Qualities 

• Demonstrated knowledge in emerging ways to utilize electronic data for collaborative delivery and payment models (e.g. RHIOs) 
• Advanced use of Microsoft Excel
• Experience in Management Service Organizations, Independent Practice Associations, or other shared service organizations. 

Additional Information: Candidate can work in a hybrid capacity (remote/in-person). 

PHS is proud to be an equal opportunity employer and encourages applications from women, people of color, persons with disabilities, LGBTQIA+ individuals, and veterans.