Payer Analytics Consultant (Temporary)Central California Alliance for Health (Remote) • United States
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Payer Analytics Consultant (Temporary)
Central California Alliance for Health (Remote)
- United States
- United States
Über
This position can be filled within any of our Alliance service areas or remotely for those residing within the state of California.
SERVICE AREA PREFERENCE
While we encourage all interested applicants to apply, we do give priority to those who live in, or near, our service counties: Santa Cruz, Monterey, Merced, San Benito, and Mariposa. Our mission of accessible, quality health care guided by local innovation leads everything we do, and having team members who are connected to the communities we serve strengthens our ability to deliver on that commitment.
WHAT YOU'LL BE RESPONSIBLE FOR
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 IDEAL CANDIDATE
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.
WHAT YOU'LL NEED TO BE SUCCESSFUL
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
Education and Experience:
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
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.
This is a temporary position and does not provide the benefits that are listed below (this is standard language from our regular job posts and cannot be altered or removed). Temporary employees on assignment at the Alliance will be connected to a staffing agency with separate benefit options.
COMPENSATION INFORMATION
Zone 1 Pay Range: $62.00 - $72.00 Typical areas in Zone 1: Santa Cruz, San Benito, and Monterey Counties, Bay Area, Sacramento, Los Angeles and San Diego areas
Zone 2 Pay Range: $58.00 - $68.00 Typical areas in Zone 2: Mariposa and Merced Counties, Fresno area, Bakersfield, Eastern California, San Luis Obispo area, and the Central Valley (except Sacramento)
The applicable salary ranges are based on work location and are aligned to a zone according to the cost of labor in your area. All ranges are subject to change in the future. We are happy to answer any questions that you have or share the applicable pay zone for your location if it’s not one of the typical areas listed.
The posted hiring ranges represent a good‑faith estimate of what a temporary employee would be paid on this assignment. Final compensation will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferable experience related to the position, education, or training), as well as other factors (internal equity, market factors, and geographic location).
At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.
The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer.
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Sprachkenntnisse
- English
Hinweis für Nutzer
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