Payer Analytics Consultant
C
Central California Alliance for HealthHealthcare reimbursement
Remote, California; Remote, Pacific, Mountain and Central Time Zones; remotely within the Pacific, Mountain and Central time zones., Pacific, Mountain and Central Time ZonesContractMiddle
Salary118,000 - 140,000 USD per year
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Job Details
- Experience
- 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).
- Required Skills
- SQLData MiningMicrosoft AccessVisual BasicTableauMicrosoft ExcelData modeling
Requirements
- Hold a bachelor’s degree in Business Administration, Accounting, Finance, Healthcare, or a related field.
- Have at least three years of experience performing financial healthcare reimbursement analysis; a Master’s degree may substitute for two years of required experience.
- Demonstrate knowledge of financial modeling and analysis methods and techniques.
- Understand provider reimbursement methodologies, pricing, and fee schedules for hospital, physician, and ancillary providers.
- Know fee-for-service and value-based provider reimbursement methodologies, including risk-sharing models.
- Understand healthcare terms and data types and structures, including member, claims, clinical, and provider data.
- Have knowledge of SQL, data modeling, business analytics, data mining, and data visualization tools such as Tableau.
- Be proficient with Windows-based PC systems and Microsoft Word, Outlook, PowerPoint, Access, Visual Basic, and Excel, including pivot tables.
- Demonstrate analytical, critical-thinking, research, data interpretation, and problem-solving skills.
- Be able to translate data into understandable information and recommend solutions that improve business processes.
Responsibilities
- Design and validate managed care payer models.
- Analyze the feasibility of payer reimbursement methodologies.
- Conduct financial analysis to support payer reimbursement outcomes.
- Coordinate and collaborate with internal and external stakeholders to achieve payer reimbursement objectives.
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