Description
Medical Mutual employees must submit their applications through MySource.
Note: This is a hybrid role based in Brooklyn, OH, requiring three days per week on-site.
Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.
Job Summary:
Designs and delivers complex financial analyses to support provider contract negotiations and strategic decision-making. Partners closely with Provider Contracting and collaborates with cross-functional subject matter experts to evaluate proposed contract terms, reimbursement structures, and negotiation strategies. Integrates financial, operational, and market insights from multiple business areas to assess risks, opportunities, and tradeoffs associated with provider agreements. Develops strategic recommendations and negotiation scenarios that support organizational objectives and executive decision-making. Leads assigned projects with minimal oversight and serves as a resource and mentor to less experienced team members.
Responsibilities:
- Partners with Provider Contracting to support provider negotiations by evaluating proposed contract terms, reimbursement arrangements, and strategic alternatives.
- Collaborates with subject matter experts across Provider Contracting, Provider Network Informatics, Pharmacy, Payment Integrity, Actuarial, Sales, Finance, and other business areas to understand negotiation components and assess their financial and operational impacts.
- Develops and maintains complex financial models and scenario analyses to quantify the impact of provider contract proposals and alternative negotiation strategies, including the evaluation of financial risks, opportunities, and tradeoffs.
- Integrate data and insights from multiple sources, including claims experience, reimbursement analyses, utilization trends, competitive market intelligence, provider performance, and membership considerations, to provide comprehensive financial assessments of provider negotiations.
- Research and analyzes provider reimbursement methodologies, market dynamics, competitive positioning, and industry trends to support negotiation strategy and business decision-making.
- Creates and presents financial analyses, reports, and executive-level materials that communicate negotiation impacts, strategic recommendations, and key decision points to management and senior leadership.
- Leads assigned projects with minimal oversight and serve as a resource and mentor to less experienced team members.
Qualifications:
Education and Experience:
- Bachelor's degree with Accounting, Finance, Analytics or Business Administration major. MBA preferred.
- 5 years of progressive finance or financial planning and analysis experience.
Technical Skills and Knowledge:
- Advanced Office skills, including Excel.
- Advanced knowledge of accounting rules and concepts and ability to apply the appropriate accounting standards to the relevant job duties.
- Knowledge of rates of return, depreciation, investments, portfolio covariance analysis.
- Proficient in the use of other automated accounting systems and an ability to serve as a training resource to junior staff members relative to the relevant systems.
- Power BI experience preferred.
Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:
A Great Place to Work:
- We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
- Employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
- On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
- Discounts at many places in and around town, just for being a Medical Mutual team member.
- The opportunity to earn cash rewards for shopping with our customers.
- Business casual attire, including jeans.
Excellent Benefits and Compensation:
- Employee bonus program.
- 401(k) with company match up to 4% and an additional company contribution.
- Health Savings Account with a company matching contribution.
- Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority.
- Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
- Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
- After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.
An Investment in You:
- Career development programs and classes.
- Mentoring and coaching to help you advance in your career.
- Tuition reimbursement up to $5,250 per year, the IRS maximum.
- Diverse, inclusive and welcoming culture with Business Resource Groups.
About Medical Mutual:
Medical Mutual's status as a mutual company means we are owned by our policyholders, not stockholders, so we don't answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.
There's a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.
We're not just one of the largest health insurance companies based in Ohio, we're also the longest running. Founded in 1934, we're proud of our rich history with the communities where we live and work.
We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.
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