Central California Alliance for Health is hiring a
Lead Payer Analytics Consultant

Summary

The Lead Payer Analytics Consultant is responsible for functioning as a strategic consultant to Alliance executive leadership in areas of complex managed care payer financial modeling and statistical analysis. They advise on organizational decision-making through the performance of complex financial analysis and act as a subject matter expert, collaborating with internal and external stakeholders to achieve payer reimbursement objectives. The Payment Strategy department ensures adequate payments to the Alliance's network. To be successful in this role, candidates must have knowledge of financial modeling and analysis methods, provider reimbursement methodologies, healthcare industry terms, financial statements, accounting principles, descriptive statistical techniques, and data management strategies. They should also possess strong analytical skills, ability to translate data into understandable information, lead and mentor staff, and collect and interpret data. A Bachelor’s degree in Business Administration, Accounting, Finance, Healthcare, or a related field, and a minimum of eight years of experience in financial healthcare reimbursement analysis are required.

Requirements

• Knowledge of methods and techniques of financial modeling and analysis
• Principles and practices of provider reimbursement methodologies, pricing, and fee schedules for all provider types
• Healthcare industry specific terms and healthcare related data types and structures
• Healthcare financial statements and accounting principles
• Descriptive statistical techniques and terminology and the principles and practices of statistical analysis
• Methods and techniques of developing and delivering data management strategies that support contract analysis, trend management, budgeting, forecasting, strategic planning, and healthcare operations
• Thorough knowledge of the methods and techniques of valuating for physician and inpatient and outpatient hospital costs

Responsibilities

• Functions as a strategic consultant to Alliance executive leadership in the areas of complex managed care payer financial modeling and statistical analysis
• Advises Alliance executive leadership on organizational decision-making through the performance of complex financial analysis
• Acts as a subject matter expert and collaborates with internal and external stakeholders to achieve payer reimbursement objectives
• Leads and trains subordinate staff