Lead Payer Analytics Consultant

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Central California Alliance for Health

πŸ’΅ $123k-$179k
πŸ“Remote - United States

Summary

Join the Alliance as a Lead Payer Analytics Consultant in the Payment Strategy Department. This position can be filled remotely within California.

Requirements

  • 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, including hospital, physician, and ancillary providers
  • Knowledge of: Healthcare industry specific terms and healthcare related data types and structures, including member, claims, clinical, and provider types
  • Knowledge of: Healthcare financial statements and accounting principles
  • Knowledge of: Descriptive statistical techniques and terminology and the principles and practices of statistical analysis
  • Knowledge of: Methods and techniques of developing and delivering data management strategies that support contract analysis, trend management, budgeting, forecasting, strategic planning, and healthcare operations
  • Knowledge of: 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
  • Ability to: Demonstrate strong analytical, critical thinking, and research skills, identify and troubleshoot issues, identify alternative solutions, and make recommendations for action
  • Ability to: Translate data into understandable information and deliver solutions that improve business processes
  • Ability to: Act as a technical resource, provide guidance related to area of assignment, and explain related regulations, processes, and programs
  • Ability to: Lead, train, mentor and motivate staff, and promote an atmosphere of teamwork and cooperation
  • Ability to: 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
  • Education and Experience: 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
This job is filled or no longer available

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