Managed Care Value-Based Analyst

Who we are

At Bon Secours Mercy Health Global Business Services – Manila, we believe your best is yet to come. Based in the Philippines, we partner with U.S.-based teams to deliver strategic insights, operational excellence and specialized expertise that advance our Mission. Join a global team focused on meaningful healthcare impact.

Job Summary

The Managed Care Value-Based Analyst is responsible for analyzing value-based payment arrangements, forecasting contract performance and supporting managed care strategy through financial and operational insights.

Operating within a Global Business Services environment, this role collaborates with managed care, finance, compliance and operational teams to evaluate payer contracts, monitor reimbursement performance and support data-driven decision-making across U.S. healthcare value-based programs.

What you'll do

• Analyze reimbursement methodologies, financial impact and contract performance to support managed care negotiations and payer strategy.
• Support the design and evaluation of value-based payment arrangements including shared savings models, quality incentive programs and risk-sharing agreements.
• Provide analytical insights and recommendations during payer negotiations and contract discussions.
• Monitor value-based program performance and identify underpayments, reimbursement variances, compliance risks and financial improvement opportunities.
• Develop forecasting models and variance analyses to evaluate contract outcomes and financial performance.
• Prepare monthly financial and operational reporting packages for leadership teams.
• Conduct quarterly and annual reconciliation reviews to validate payer compliance with contractual payment terms.
• Analyze payer claims data, market trends and industry developments to support strategic decision-making.
• Build and maintain dashboards and reporting tools to track key performance indicators and value-based metrics.
• Perform ad hoc analyses to support process improvement initiatives, budgeting activities and scenario modeling for new contract terms.
• Collaborate with cross-functional stakeholders to interpret payer policies, reimbursement requirements and contract provisions.
• Ensure accuracy, integrity and confidentiality of healthcare and payer data in accordance with organizational policies and regulatory requirements.

What you'll bring

Experience

• 3+ years of experience in managed care analytics, healthcare finance, payer analytics, medical economics or healthcare consulting required.
• Experience supporting value-based contract development including performance measurement, attribution methodologies, quality metrics, reconciliation processes and payment dispute resolution required.
• Experience developing forecasting models, reimbursement analyses and variance reporting required.
• Experience creating Tableau dashboards and reports required.
• Experience partnering with managed care, finance, legal, compliance and operational stakeholders preferred.

Education

• Bachelor's degree in Information Systems, Business Administration, Finance, Accounting, Healthcare Administration, Economics, Analytics or a related field required.
• Master's degree in Business Administration, Healthcare Administration, Public Health, Finance or a related field preferred.

Certifications

• Certified Healthcare Financial Professional (CHFP) – Healthcare Financial Management Association preferred.
• Certified Professional in Healthcare Quality (CPHQ) – National Association for Healthcare Quality preferred.

Knowledge, Skills and Abilities

• Knowledge of managed care contracts, reimbursement methodologies and value-based payment models.
• Advanced analytical and problem-solving skills with the ability to interpret complex financial and healthcare data.
• Advanced Microsoft Excel skills including financial modeling, forecasting and scenario analysis.
• Strong Structured Query Language (SQL) skills with experience analyzing large healthcare claims and reimbursement datasets.
• Ability to interpret complex contractual language and assess financial, operational and compliance impacts.
• Experience validating value-based payment settlements and reconciliation methodologies.
• Proficiency in data visualization and reporting tools such as Tableau and Microsoft Power BI.
• Strong written and verbal communication skills with the ability to present findings to technical and non-technical audiences.
• Excellent organizational skills and attention to detail.
• Ability to manage multiple priorities and deliver high-quality analysis within deadlines.
• Commitment to maintaining confidentiality of patient, payer and organizational information.

What we offer

• Comprehensive HMO medical coverage, retirement plan and group life and accident insurance
• One-time Work From Home allowance, connectivity allowance and wellness allowance
• Paid vacation and sick leave
• Government-mandated benefits: SSS, PhilHealth and Pag-IBIG contributions
• Flexible working model based on role and business need
• Mission-driven culture events, outreach and service opportunities
• Learning and development programs, mentorship and career growth pathways
• Collaborative office spaces and engagement activities

Benefits may vary based on employment terms and role.