Pricing Analyst

J  o  b    D  e  s  c  r  i  p  t  i  o  n

JOB INFORMATION

Effective Date:

12/1/2021

Entity:

Wisconsin

Job Code:

450017

Job Title:

Pricing Analyst

FLSA Exemption Status:

Exempt

Management Level:

Individual Contributor

JOB SUMMARY

Under the general direction of the Manager of Charge Capture, the Pricing Analyst is responsible for collecting, analyzing, and monitoring the organization's pricing, cost, and budget data to positively impact financial performance and outcomes. The Analyst will need to utilize a variety of analytical methods, tools, models and techniques, as well as to translate government requirements to evaluate complex requests or situations. Other responsibilities include, but are not limited to, responsibility for assisting with the annual financial review processes, assisting with the annual CPT code change process, assisting with the annual Pricing Transparency Process, analysis and identification of revenue leakage, and reporting.

ESSENTIAL DUTIES

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Core Responsibilities: Incumbent performs job while demonstrating an understanding of job expectations and compliance with organization policies and procedures:

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Assist with annual rate establishment processes for both hospital and professional billing, for UW Health and SwedishAmerican, including but not limited to:

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o Obtaining benchmarking data, volumes, reimbursement, and other information required to complete annual fee review to ensure pricing remains current and competitive

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o Compile data

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o Reporting as needed

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Assist with annual CPT code change process for both hospital and professional billing, for UW Health and SwedishAmerican, including but not limited to:

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o Communication with various stakeholder groups such as Coding, Contracting, IT, etc.

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o Compile data

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o Reporting as needed

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Assist with annual Pricing Transparency changes for UW Health and SwedishAmerican, including but not limited to:

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o Obtaining file exports from Epic

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o Preparing and validating data to be published

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o Reporting as needed

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Utilize knowledge of the healthcare industry, clinical and/or business workflows to propose data driven solutions and improvements while working collaboratively with various stakeholders

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Proactively develop and maintain a working knowledge of the UW Health organizational structure, core leaders, decision makers, functional areas, and the market. Apply knowledge of the organization to help optimize the efficiency and success of client engagements, projects, and task completion

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Utilize SQL and other query tools to analyze large quantities of data, from multiple complex internal and external sources to glean understanding, derive actionable insights into organizational performance and the external environment, and measure progress toward strategic initiatives

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Participates in efforts to review and analyze the chargemaster (CDM) to ensure consistency with industry standards and to ensure that change in pricing, CPT/HCPCS codes, and revenue codes are accurate and compliant with billing regulations

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Continuously advance expertise in data analytics competencies

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Develop, produce, validate, and distribute standard charge-related reports and ad-hoc reports as needed

As needed, additional responsibilities reasonably within the scope of duties and physical requirements may be assigned.  ALL DUTIES AND REQUIREMENTS MUST BE PERFORMED CONSISTENT WITH THE UW HEALTH PERFORMANCE STANDARDS AND RESPECT FOR PEOPLE COMMITTMENTS.

X

Non-Clinical

JOB REQUIREMENTS

Bachelor's Degree

in Accounting, Finance, Business, Healthcare, Analytics or another related field.

Required

Master's Degree

in Accounting, Finance, Business, Healthcare, Analytics or another related field.

Preferred

2 years

of experience in accounting, finance or analytics that includes experience with computer systems, spreadsheet and database applications, data reporting and interpretation

Required

4 years

of experience in accounting, finance or analytics that includes experience with computer systems, spreadsheet and database applications, data reporting and interpretation, as well as experience using Epic Clarity, SQL, and Epic Chronicles in a healthcare or business administration setting

Preferred

Epic certification in any area

CPA

Preferred

LICENSE, CERTIFICATIONS, AND REGISTRATIONS MUST BE MAINTAINED PER UW HEALTH POLICY. 

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Advanced financial and analytical skills:

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o Knowledge of Generally Accepted Accounting Principles (GAAP) and governmental regulations as applied to health care financial management

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o Knowledge of SQL, Clarity, and/or other analytical reporting tools

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o Demonstrates professional standards surrounding data access, security, sensitivity, and confidentiality

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o Ability to analyze data and workflows to identify complex problems and issues to recommend solutions

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o Ability to make good judgments in demanding situations

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Advanced leadership skills:

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o Advanced communication skills both written and verbal

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o Ability to develop goals, objectives, and establish priorities

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o Ability to implement change in a positive, sensitive, and forward-thinking manner

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o Inspire confidence, good judgment, and the ability to act decisively at the right time

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o Self-starter with a willingness to try new ideas

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o Positive, can-do attitude coupled with a sense of urgency

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Advanced technical skills:

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o Thorough knowledge and experience in financial system applications and software

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o Experience in database development and management

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o Experience in Microsoft Office Suite (Excel, Access, Word, Outlook, and Power Point)

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o Experience using Epic EHR applications

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o Knowledge of maintain and auditing the chargemaster (CDM)

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Strong customer service and human relations abilities

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o Ability to effect collaborative alliances and promote teamwork

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o Ability to ensure a high level of customer satisfaction including employees, patients, visitors, faculty, referring physicians and external stakeholders

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Ability to network with Revenue Cycle/Integrity leaders from other organizations

PHYSICAL REQUIREMENTS/WORKING CONDITIONS

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Sedentary: Ability to lift up to 10 pounds maximum and occasionally lifting and/or carrying such articles as dockets, ledgers and small tools. Although a sedentary job is defined as one, which involves sitting, a certain amount of walking and standing is often necessary in carrying out job duties. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Up to 10#

Negligible

Negligible

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Light: Ability to lift up to 20 pounds maximum with frequent lifting and/or carrying of objects weighing up to 10 pounds. Even though the weight lifted may only be negligible amount, a job is in this category when it requires walking or standing to a significant degree.

up to 20#

Up to 10# or requires significant walking or standing or requires pushing/pulling of arm/leg controls.

Negligible or constant push/pull of items of negligible weight

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Medium: Ability to lift up to 50 pounds maximum with frequent lifting and/or carrying objects weighing up to 25 pounds.

20-50#

10-25#

Negligible-10#

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Heavy: Ability to lift up to 100 pounds maximum with frequent lifting and/or carrying objects weighing up to 50 pounds.

50-100#

25-50#

10-20#

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Very Heavy: Ability to lift over 100 pounds with frequent lifting and/or carrying objects weighing over 50 pounds.

Over 100#

Over 50#

Over 20#

Other - list any other physical requirements or bona fide occupational qualifications not indicated above:

Over 50 lbs.

UW Health does not require, nor does it expect that its employees lift more than 50 lbs unassisted. Objects in excess of 50 lbs should be lifted or moved with mechanical means or through a team lift. Employees in patient care areas are expected to utilize mechanical lifts and adhere to the "Use of Mechanical Lifts (Liko)" policy in the Patient Services Policy and Procedure Manual.

Note: The purpose of this document is to describe the general nature and level of work performed by personnel so classified; it is not intended to serve as an inclusive list of all responsibilities associated with this position.

THE EMPLOYEE MUST BE ABLE TO COMPLETE ALL PHYSICAL REQUIREMENTS OF THE JOB WITH OR WITHOUT AN APPROVED ACCOMODATION. Note: The purpose of this document is to describe the general nature and level of work performed by personnel so classified; it is not intended to serve as an inclusive list of all responsibilities associated with this position.