Lead Payer Analytics Consultant

Summary

Join us at Central California Alliance for Health (the Alliance) as a Lead Payer Analytics Consultant in the Payment Strategy Department. This position can be filled remotely within the Pacific or Mountain Time Zones.

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, including hospital, physician, and ancillary providers
• Healthcare industry specific terms and healthcare related data types and structures, including member, claims, clinical, and provider types
• 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
• 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
• Lead, train, mentor and motivate staff, and promote an atmosphere of teamwork and cooperation
• Organize and prioritize the work of others and follow up on work assignments
• Education and Experience: Bachelor’s degree in Business Administration, Accounting, Finance, Healthcare, or a related field
• A minimum of eight 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

Responsibilities

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

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