Payer Analytics Consultant

Job Summary

Reporting to the Payment Strategy Director, the Payer Analytics Consultant (Defined Term) will perform complex financial analysis and design payer models to evaluate reimbursement methodologies while working remotely in the Pacific, Mountain, and Central time zones.

Key responsibilities

• Design and validate managed care payer models and conduct financial analyses to support payer reimbursement outcomes
• Coordinate with internal and external stakeholders to achieve payer reimbursement objectives
• Analyze data to inform decision-making and optimize payment accuracy

Required qualifications

• Bachelor's degree in Business Administration, Accounting, Finance, Healthcare, or a related field
• A minimum of three years of experience in financial healthcare reimbursement analysis
• Proficient in financial modeling techniques and reimbursement methodologies
• Experience with data visualization tools, such as Tableau, and data analysis tools, including SQL
• Knowledge of healthcare industry terms and data structures related to member, claims, and provider types