Payer Analytics Consultant

Technically strong with proven experience in payer financial modeling, provider payment methodologies, payment structure design, and reimbursement strategy development Analytical and detail-oriented, skilled in data interpretation, trend analysis, and scenario modeling Collaborative and solutions-focused, working effectively across departments Clear and professional communicator, able to explain complex financial and analytical concepts Relationship-driven, fostering productive partnerships Knowledge of Windows-based PC systems and Microsoft Word, Outlook, PowerPoint, Access, Visual Basic, and Excel (including pivot tables), and database systems Knowledge of methods and techniques of financial modeling and analysis Knowledge of principles and practices of provider reimbursement methodologies, pricing, and fee schedules for all provider types Knowledge of healthcare industry specific terms and healthcare related data types and structures Knowledge of national standards for fee-for-service and value-based provider reimbursement methodologies Knowledge of 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 Translate data into understandable information and deliver solutions that improve business processes Act as a technical resource, provide guidance related to area of assignment Interpret and apply rules, regulations, policies, procedures, and guides Work collaboratively with individuals at all levels of the organization while supporting multiple stakeholders 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

Designs and validates managed care payer models 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