Payor Contracting Analyst
About The Position
The Payor Contracting Analyst provides analysis of revenue, market share, capacity, and develops optimal pricing for geographies and market segments aligned with Ivy Fertility’s overall strategy. This role conducts market research, assesses data, and develops insights into market trends and pricing strategies. The Payor Contracting Analyst maintains historical pricing data to monitor and evaluate the effectiveness of payer contracts and coordinates tools, reports, and communications to ensure accurate pricing information that remains responsive to market changes. This position reports directly to the Chief Payor Strategy Officer.
Requirements
- Bachelor’s degree in business, healthcare administration, marketing, or a related field required
- Two or more years of experience in payor strategy, payor contract modeling, managed care contracting, or related roles within women’s health organizations preferred
- Experience with healthcare payer dynamics, reimbursement models, and the health insurance landscape preferred
Responsibilities
- Conduct in-depth analysis of payer trends, market dynamics, competitor pricing, and reimbursement strategies to identify opportunities and potential challenges
- Design and execute reimbursement strategies to support optimal coverage and reimbursement while maximizing patient access
- Generate evidence supporting the value proposition of Ivy Fertility’s offerings to support pricing and reimbursement discussions with payers
- Partner with internal teams, including marketing, finance, and legal, to align overall payer strategies
- Stay up to date on healthcare industry trends and payer policies on a monthly and quarterly basis
- Perform other duties as assigned
- Build contract impact models, manage fee schedules, and conduct contract rate evaluations
- Serve as subject matter expert and administrator for the RIVET tool for benchmarking and model analysis
- Manage payor rate documentation, request fee schedules and exhibit updates from contracted payors, and monitor negotiation and contract termination timelines using team trackers and calendars
- Monitor and evaluate the performance of payer contracts and reimbursement initiatives, making data-driven adjustments as needed
- Complete administrative tasks related to managed care contract proposals
- Assist with monitoring and analyzing financial performance and support claims-related projects
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
11-50 employees
