Hybrid Payer Analytics Consultant – Temporary

at Central California Alliance for Health

• Job title: Payer Analytics Consultant – Temporary
• Job type: Contract
• Experience level: Mid level, Senior
• Salary: $58,000 - $72,000 per year
• Degree requirement: Bachelor's Degree
• Tech skills: SQL, Tableau
• Location requirements: Hybrid, United States

About the role

• Payer Analytics Consultant responsible for developing healthcare reimbursement strategies. Collaborating with various stakeholders to ensure effective payer reimbursement outcomes while serving Central California.

Responsibilities

• Designs and validates managed care payer models and performs moderately complex analysis to evaluate the feasibility of payer reimbursement methodologies
• Conducts moderately complex financial analysis to support successful payer reimbursement outcomes
• Coordinates and collaborates with internal and external stakeholders to achieve payer reimbursement objectives

Requirements

• Bachelor’s degree in Business Administration, Accounting, Finance, Healthcare, or a related field
• A minimum of three 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
• Knowledge of Windows based PC systems and Microsoft Word, Outlook, PowerPoint, Access, Visual Basic, and Excel (including pivot tables), and database systems
• 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
• National standards for fee-for-service and value-based provider reimbursement methodologies, including risk-sharing models
• Data modeling techniques and business analytical and data mining tools, including SQL, and data visualization tools, such as Tableau
• 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
• Interpret and apply rules, regulations, policies, procedures, and guides
• Work collaboratively with individuals at all levels of the organization while supporting multiple stakeholders.

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