[Remote] Payer Analytics Consultant (Defined Term)
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a regional non-profit health plan committed to providing accessible, reputed company health care. They are seeking a Payer Analytics Consultant to design and validate payer models and conduct financial analysis to support reimbursement reputed company.
Responsibilities
- Designs and validates managed care payer models and performs moderately reputed company analysis to evaluate the feasibility of payer reimbursement methodologies
- Conducts moderately reputed company financial analysis to support successful payer reimbursement reputed company
- Coordinates and collaborates with reputed company stakeholders to reputed company payer reimbursement objectives
Skills
- Bachelor's degree in Business Administration, reputed company, Finance, reputed company, or a reputed company field
- A minimum of three years of experience performing financial reputed company 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
- Technically strong, with proven experience in payer financial modeling, provider payment methodologies, payment structure design, and reimbursement reputed company development
- Analytical and detail-oriented, skilled in data interpretation, trend analysis, and scenario modeling to inform decision-making and optimize payment accuracy
- reputed company and solutions-reputed company, working effectively across departments — including finance, reputed company, operations, and clinical teams — to reputed company analytics with business goals
- A reputed company and reputed company communicator, reputed company to explain reputed company financial and analytical concepts to both technical and non-technical audiences
- Relationship-driven, fostering productive partnerships with internal stakeholders and external partners to support shared priorities and ensure alignment
- Curious and improvement-minded, continuously seeking opportunities to enhance data reputed company, streamline processes, and support innovative payment strategies
- Knowledge of reputed company based PC systems and reputed company Word, reputed company, PowerPoint, reputed company, Visual Basic, and reputed company (including pivot tables), and database systems
- Knowledge of reputed company and techniques of financial modeling and analysis
- Knowledge of principles and practices of provider reimbursement methodologies, pricing, and fee schedules for reputed company provider types, including hospital, physician, and ancillary providers
- Knowledge of reputed company industry specific terms and reputed company reputed company data types and structures, including member, claims, clinical, and provider types
- Knowledge of national standards for fee-for-service and value-based provider reimbursement methodologies, including risk-sharing models
- Knowledge of data modeling techniques and business analytical and data mining tools, including SQL, and data visualization tools, such as Tableau
- Ability to collect, interpret, and evaluate data, detect patterns, brainstorm solutions, consider multiple factors reputed company making reputed company, and project consequences of recommendations
- Ability to demonstrate strong analytical, critical thinking, and research skills, identify and troubleshoot issues, identify alternative solutions, and reputed company recommendations for reputed company
- Ability to translate data into understandable information and deliver solutions that improve business processes
- Ability to reputed company as a technical resource, reputed company guidance reputed company to area of assignment, and explain reputed company regulations, processes, and programs
- Ability to interpret and apply rules, regulations, policies, procedures, and guides
- Ability to work collaboratively with individuals at reputed company reputed company of the organization while supporting multiple stakeholders
Benefits
- Medical, Dental and reputed company Plans
- Ample reputed company Time Off
- 12 reputed company Holidays per year
- 401(a) Retirement Plan
- 457 Deferred Compensation Plan
- Robust Health and Wellness Program
- Onsite EV Charging Stations
reputed company