Lead Payer Analytics Consultant
New Today
Overview We have an opportunity to join the Alliance as a Lead Payer Analytics Consultant in the Payment Strategy Department. There are two positions that can be filled remotely for those living in California.
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
About the Team The Payment Strategy department ensures the Alliance’s payments to our network are adequate to our revenue. We also work to advance our payment methodology in order to achieve the best quality healthcare while reducing costs.
The Ideal Candidate An experienced analytical and collaborative lead, with direct experience with complex medical payor modeling
Technically strong, with skill in provider reimbursement modeling, payment structure design and reimbursement strategies
A collaborative and professional communication style, building productive relationships supporting multiple stakeholders
Experience with Medicare and/or Medi-Cal (Medicaid) a plus
What You’ll Need to Be Successful To read the full position description, and list of requirements please view the attached link.
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
Methods and techniques of developing and delivering data management strategies that support contract analysis, trend management, budgeting, forecasting, strategic planning, and healthcare operations
National standards for fee-for-service and value-based provider reimbursement methodologies, including risk-sharing models
Ability to: Demonstrate strong analytical, critical thinking, and research skills, identify and troubleshoot issues, identify alternative solutions, and make recommendations for action
Be 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
Produce organized, accurate, and detail-oriented work in a fast-paced environment and under the pressure of deadlines
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
Other Information We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams. While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected. In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.
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- Location:
- Washington, DC, United States
- Salary:
- $200,000 - $250,000
- Job Type:
- FullTime
- Category:
- Consulting