About this role
Thank you for considering a career at Bon Secours Mercy Health! 

Scheduled Weekly Hours: 40

Work Shift: 9pm to 6am (Philippines)

Job Summary: This position is a senior individual contributor within the Managed Care team in Global Business Services (GBS). The Managed Care Value-Based Expert provides subject-matter expertise and advanced analytical support for managed care contracting value-based payment arrangements. The role leads complex financial modeling, proforma development, contract performance evaluation, and reconciliation activities across value-based payment models, informing negotiation strategy, contract compliance assessments, financial performance and enterprise decision-making in partnership with managed care leadership.
Essential Functions:
• Prepare advanced reimbursement, financial impact, and performance analyses to support managed care contract negotiations and payer strategy. • Design and evaluate value-based payment models, including shared savings, quality metrics, risk corridors, and attribution methodologies. • Conduct pro forma and sensitivity analyses to estimate the financial value of proposed contract changes, cost containment initiatives, and industry trends. Conduct sensitivity analyses and stress testing on models to understand the range of potential outcomes under multiple utilization and cost scenarios. • Monitor and analyze contract and value-based program performance, identify underpayments, compliance gaps, unfavorable payment trends, and financial risks. • Develop monthly forecasts and financial packages summarizing value-based performance, payment reconciliation, and variance analysis. • Conduct quarterly and annual reconciliation audits for value-based programs, ensuring payer compliance with contractual terms and identifying areas of non-compliance affecting contract performance. • Develop and implement innovative tools and methodologies to monitor healthcare trends to accurately forecast value-based performance. • Synthesize insights from payer data, market trends, and industry developments to inform negotiation strategy and enterprise decision-making. • Create executive-ready visualizations for contract performance and financial forecasting tailored to different stakeholder audiences (clinical vs. financial). Build repeatable analytic processes that scale across programs. • Mentor Managed Care Analysts, provide technical guidance, and contribute to analytical standards and process improvements within the team.
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 Information Systems, Business Administration, Finance, Accounting, Healthcare Administration, Economics, Analytics, or related discipline (required) • Master’s degree in Business Administration (MBA), Healthcare Administration (MHA), Public Health (MPH), Finance, or related field (preferred)
Required Licensing & Certifications:
• Certified Healthcare Financial Professional (CHFP) — Healthcare Financial Management Association (HFMA) (preferred) • Certified Professional in Healthcare Quality (CPHQ) — National Association for Healthcare Quality (NAHQ) (preferred)
Experience:
• 5 years of progressive experience in healthcare finance, payer analytics, medical economics, or related healthcare consulting (required) • Demonstrable track record of building analytics that drive business decisions and actions (required) • Demonstrated experience supporting value-based contract development, including performance measurement, attribution/quality metrics, reconciliation, and dispute resolution/appeals processes (required) • Experience with forecasting, audit, and predictive analytics to support negotiation and contract performance management (required) • Demonstrated experience extracting, validating, and analyzing large healthcare claims, reimbursement, and/or value-based performance datasets (required)
Skills & Abilities:
• Ability to ensure the confidentiality and rights of patients, as well as the confidentiality of hospital and departmental documents. • Must have knowledge regarding analytical tools and techniques. • Work requires a high level of critical thinking and problem-solving skills. • Must exhibit a positive demeanor, good verbal and written communication skills, and maintain professionalism in both appearance and approach • Proficient in the Microsoft Office Suite with advanced Excel skills, especially around data manipulation and analysis. • Deep understanding of managed care contract structures, payment methodologies, and reimbursement analytics. • Proficient in interpreting contract terms and their financial impact. • Advanced Microsoft Excel skills (modeling, scenario analysis, PivotTables). • Familiarity with data visualization tools (Power BI, Tableau) and SQL-based reporting. • Strong interpersonal skills with ability to communicate technical information to non-technical audiences. • Highly organized, detail-oriented, and capable of handling multiple projects independently. • Ability to synthesize data from multiple data sources both internal and external to inform payer negotiation strategy.
Training: N/A 

As a Bon Secours Mercy Health associate, you’re part of a Mission that matters. We support your well-being – personally and professionally. Our benefits are built to grow with you and meet your unique needs, every step of the way.
What we offer
• Comprehensive HMO medical coverage, retirement plan and group life and accident insurance
• One-time Work From Home allowance, connectivity allowance, wellness allowance and role-specific allowances
• Paid vacation and sick leave
• Government-mandated benefits: SSS, PhilHealth and Pag-IBIG contributions
• Flexible working model with hybrid, onsite or virtual arrangements (based on role and business need)
• Mission-driven culture events, community outreach and service opportunities
• Learning and development programs, mentorship and clear career growth pathways
• Modern, collaborative office spaces and regular engagement and culture-building activities
Benefits may vary based on employment terms and role. 

Department: Revenue Management - Managed Care - BSMH Global Business Systems

It is our policy to comply with all applicable Philippine labor laws and regulations and to uphold equal employment opportunity in all aspects of recruitment and employment.
All applicants will be considered for employment based on merit, qualifications, and business requirements, without regard to race, color, ethnicity, religion, sex, sexual orientation, gender identity or expression, civil status, age, disability, genetic information, nationality, or any other status protected under Philippine law.
We are committed to providing an inclusive workplace free from unlawful discrimination and harassment.
If you are a person with a disability and require reasonable accommodation as part of the application or selection process, please contact the Talent Acquisition Team at mnl.recruitment@bsmhealth.org. We will work with you to provide appropriate assistance in accordance with applicable laws and company policy.