Privia Health-posted 1 day ago
$76,000 - $85,000/Yr
Full-time • Entry Level
Remote
1,001-5,000 employees

The Payer Contracting Analyst is a key contributor on our Payer Contracting team in enabling both the team and other departments to make better data driven decisions on financial, operational, and clinical initiatives. This position will play a key supporting role in the development, analysis, and optimization of commercial and government payer contracts within the organization. This role covers internal and external customers and requires working cross-functionally to understand evolving business needs and requirements. This Privia Partner will be responsible for helping to design and develop reports, presentations, and models to guide strategic decision making of our stakeholders. The Analyst works to deliver data-driven insights to key stakeholders across the enterprise. The Analyst assists in the development of end-to-end analytics solutions efforts, working with cross-functional teams to deliver on evolving requirements and business needs, build scalable reports and applications, and deliver solutions that ultimately empower end-users in making data-driven business decisions. The Analyst also supports the execution of business- and client-facing ad hoc analyses, using data to guide strategic discussions among and between internal and external stakeholders.

  • Conduct quantitative analyses to evaluate payer performance, utilization trends, cost drivers, and reimbursement outcomes.
  • Develop insights that support contract strategies, rate negotiations, and value-based care program underwriting.
  • Responsible for assessing legal and financial implications of all contracting opportunities, including new contacts, contractual amendments and assignments to existing contracts.
  • Build and maintain fee schedule models to forecast expected reimbursement under various contract terms.
  • Perform scenario analysis and assess financial impacts of proposed rate changes, proposals, or contract structures.
  • Assist in the development of value-based care financial models, including shared savings, bundled payments, quality incentive programs, and care coordination fees.
  • Support ongoing monitoring of value-based program performance and emerging opportunities.
  • Write SQL queries to extract and analyze medical claims data.
  • Develop standardized reports and dashboards used for internal reviews and external payerdiscussions.
  • Ensure data accuracy, completeness, and consistency across analytical deliverables.
  • Work closely with the Payer Contracting team to translate analytical findings into compelling insights that inform negotiation strategy.
  • Collaborate with our Revenue Optimization and Payer Contracting teams to develop reports andalerts that will ensure that Privia is being paid appropriately for fee-for-service andpay-for-performance contracts.
  • Partner with Finance, Population Health, Revenue Cycle, and Clinical Operations teams as needed.
  • Bachelor’s degree in a quantitative field (e.g., Economics, Finance, Statistics, Mathematics, Computer Science) or equivalent experience, preferably within a healthcare environment.
  • Experience using SQL
  • Strong Microsoft Excel skills, including pivot tables and advanced formulas
  • 1+ years experience working with healthcare claims data preferred
  • Strong project management and analytical skills, including a desire to logically solve business andtechnology problems
  • Must comply with HIPAA rules and regulations
  • Innovative, resourceful, and outcome-driven
  • Ability to successfully manage multiple competing priorities
  • High attention to detail and quality control
  • Strong verbal and written communication skills
  • Excellent critical thinking skills and proven track record with presenting quantitative information tonon-technical stakeholders
  • medical
  • dental
  • vision
  • life
  • pet insurance
  • 401K
  • paid time off
  • other wellness programs
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