Senior Payer Analytics Consultant

October 27

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Central California Alliance for Health

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501 - 1000 employees

Founded 1996

⚕️ Healthcare Insurance

🧘 Wellness

Description

• Reporting to the Payment Strategy Director, this position: • Performs complex managed care payer financial modeling and analysis to evaluate the feasibility of payer reimbursement methodologies • Conducts complex financial analysis to support successful payer reimbursement outcomes • Coordinates and collaborates with internal and external stakeholders to achieve payer reimbursement objectives • Provides subject matter expertise and assists with providing orientation, mentoring, and training to subordinate Payer Analytics Consultants

Requirements

• Knowledge of: • Methods and techniques of financial modeling and analysis • Windows based PC systems and Microsoft Word, Outlook, PowerPoint, Access, Visual Basic, and Excel (including pivot tables), and database systems • Principles and practices of provider reimbursement methodologies, pricing, and fee schedules for all provider types, including hospital, physician, and ancillary providers • Various types of health insurance payers, including Medicare, Medicaid, and commercial plans • Healthcare industry specific terms and healthcare related data types and structures, including member, claims, clinical, and provider types • Healthcare financial statements and accounting principles • 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 • Assist with the orientation, training, and mentoring of other staff, as assigned • Education and Experience: • Bachelor’s degree in Business Administration, Accounting, Finance, Healthcare, or a related field • A minimum of five 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