Lead Payer Analytics Consultant

September 29

Apply Now

Receive Emails with Similar Jobs

Central California Alliance for Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1996

⚕️ Healthcare Insurance

🧘 Wellness

Description

• We have an opportunity to join the Alliance as a Lead Payer Analytics Consultant in the Payment Strategy Department. This position can be filled remotely within California. • Functions as a strategic consultant to Alliance executive leadership in the areas of complex managed care payer financial modeling and statistical analysis to evaluate the feasibility of payer reimbursement methodologies. • Advises Alliance executive leadership on organizational decision-making through the performance of complex financial analysis to support successful payer reimbursement outcomes. • Acts as subject matter expert and collaborates with internal and external stakeholders to achieve payer reimbursement objectives. • Acts as a subject matter expert and lead to subordinate staff.

Requirements

• Knowledge of: • Methods and techniques of financial modeling and analysis • Principles and practices of provider reimbursement methodologies, pricing, and fee schedules for all provider types, including hospital, physician, and ancillary providers • Healthcare industry specific terms and healthcare related data types and structures, including member, claims, clinical, and provider types • Healthcare financial statements and accounting principles • Descriptive statistical techniques and terminology and the principles and practices of statistical analysis • Methods and techniques of developing and delivering data management strategies that support contract analysis, trend management, budgeting, forecasting, strategic planning, and healthcare operations • Thorough knowledge of the methods and techniques of valuating for physician and inpatient and outpatient hospital costs • Ability to: • Collect, interpret, and evaluate data, detect patterns, brainstorm solutions, consider multiple factors when making decisions, and project consequences of recommendations • Demonstrate strong analytical, critical thinking, and research skills, identify and troubleshoot issues, identify alternative solutions, and make recommendations for action • Translate data into understandable information and deliver solutions that improve business processes • Act as a technical resource, provide guidance related to area of assignment, and explain related regulations, processes, and programs • Lead, train, mentor and motivate staff, and promote an atmosphere of teamwork and cooperation • Organize and prioritize the work of others and follow up on work assignments • Education and Experience: • Bachelor’s degree in Business Administration, Accounting, Finance, Healthcare, or a related field • A minimum of eight years of experience performing financial healthcare reimbursement analysis (a Master’s degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying

Benefits

• Medical, Dental and Vision Plans • Ample Paid Time Off • 12 Paid Holidays per year • 401(a) Retirement Plan • 457 Deferred Compensation Plan • Robust Health and Wellness Program • Onsite EV Charging Stations