Payer Analytics Consultant (Temporary)
About The Position
This is a temporary position and the length of assignment is estimated to go from through December 31, 2026. The length of the assignment is always dependent on business need and dates may change. While the assignment would be at the Alliance, if selected, you would be an employee of a temporary employment agency that we would connect you with. This position can be filled within any of our Alliance service areas or remotely for those residing within the state of California. Reporting to the Payment Strategy Director, this position: Designs and validates managed care payer models and performs moderately complex analysis to evaluate the feasibility of payer reimbursement methodologies Conducts moderately complex financial analysis to support successful payer reimbursement outcomes Coordinates and collaborates with internal and external stakeholders to achieve payer reimbursement objectives 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. Technically strong, with proven experience in payer financial modeling, provider payment methodologies, payment structure design, and reimbursement strategy development. Analytical and detail-oriented, skilled in data interpretation, trend analysis, and scenario modeling to inform decision-making and optimize payment accuracy. Collaborative and solutions-focused, working effectively across departments — including finance, provider network management, operations, and clinical teams — to align analytics with business goals. A clear and professional communicator, able to explain complex 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 quality, streamline processes, and support innovative payment strategies.
Requirements
- Knowledge of Windows based PC systems and Microsoft Word, Outlook, PowerPoint, Access, Visual Basic, and Excel (including pivot tables), and database systems
- 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
- National standards for fee-for-service and value-based provider reimbursement methodologies, including risk-sharing models
- 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 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
- Interpret and apply rules, regulations, policies, procedures, and guides
- Work collaboratively with individuals at all levels of the organization while supporting multiple stakeholders
- Bachelor’s degree in Business Administration, Accounting, Finance, Healthcare, or a related field
- A minimum of three 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
- Designs and validates managed care payer models and performs moderately complex analysis to evaluate the feasibility of payer reimbursement methodologies
- Conducts moderately complex financial analysis to support successful payer reimbursement outcomes
- Coordinates and collaborates with internal and external stakeholders to achieve payer reimbursement objectives
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What This Job Offers
Career Level
Mid Level
