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Senior Payer Analytics Consultant

central
(Central California Alliance for Health)

LOCATION: Scotts Valley, California; Salinas, CA; Merced, CA

We have an opportunity to join the Alliance as a Senior Payer Analytics Consultant in the Financial Planning and Analysis Department.

WHAT YOU’LL BE RESPONSIBLE FOR:

  • Perform complex managed care payer financial modeling and analysis to evaluate the feasibility of payer reimbursement methodologies
  • Conduct complex financial analysis to support successful payer reimbursement outcomes
  • Coordinate and collaborate with internal and external stakeholders to achieve payer reimbursement objectives

ABOUT THE TEAM: We ensure the Alliance’s stewardship of appropriate use of public funds through recoveries, coordination of benefits, contract negotiations and insurance.

WHAT YOU’LL NEED TO BE SUCCESSFUL: To read the full position description, and list of requirements, click here.

Knowledge of:

  • Methods and techniques of financial analysis
  • Windows based PC systems and Microsoft Word, Outlook, PowerPoint, Access, Visual Basic, and Excel (including pivot tables), and database systems
  • Principles and practices of provider reimbursement methodologies, pricing, and fee schedules for all provider types, including hospital, physician, and ancillary providers
  • The various types of health insurance payers, including Medicare, Medicaid, and commercial plans
  • The healthcare industry specific terms and healthcare related data types and structures, including member, claims, clinical, and provider types

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
  • Manage multiple projects simultaneously, organize work, ensure accuracy of data, maintain accurate records, and achieve goals and timelines
  • Interpret and apply rules, regulations, policies, procedures, and guides
  • Lead and facilitate meetings

Education and Experience:

  • Bachelor’s degree in Business Administration, Accounting, Finance, Healthcare, or a related field
  • A minimum of five 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 DETAILS:

  • While this position is connected to one of our Alliance offices, we are in hybrid remote/in-office work environment right now and we anticipate that the interview process will take place remotely.
  • Our Alliance office locations have officially re-opened as of May 2, 2022 and while some employees may work in full-time telecommute schedules, attendance at quarterly company-wide events or department meetings will be expected.
  • Based on the nature of work, this position may require onsite presence, which is dependent on business need. Details about this can be reviewed during the interview process.

Additionally, all positions at the Alliance are required to meet these minimum qualifications.

OUR BENEFITS:

  • Medical, Dental and Vision Plans
  • Ample Paid Time Off
  • 11 Paid Holidays per year
  • 401(a) Retirement Plan
  • 457 Deferred Compensation Plan
  • Robust Health and Wellness Program
  • Onsite EV Charging Stations
  • And many more

HOW TO APPLY: If interested, please submit an online application here.

ABOUT US: We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.

Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Merced, Monterey and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet.