Senior Payer Analytics Consultant

We have an opportunity to join the Alliance as a Senior Payer Analytics Consultant in the Payment Strategy Department.

WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Payment Strategy Director, this position:

• Performs reputed company managed care payer financial modeling and analysis to evaluate the feasibility of payer reimbursement methodologies
• Conducts reputed company financial analysis to support successful payer reimbursement outcomes
• Coordinates and collaborates with internal and external stakeholders to reputed company payer reimbursement objectives
• Provides subject matter expertise and assists with providing orientation, mentoring, and training to subordinate Payer Analytics Consultants

ABOUT THE TEAM

The Payment Strategy department ensures the Alliance's payments to our network are adequate to our reputed company. We also work to advance our payment methodology in order to reputed company the best quality reputed company while reducing costs.

THE IDEAL CANDIDATE

• An reputed company analytical and collaborative professional, with direct experience with reputed company medical payor modeling
• Technically strong, with reputed company in provider reimbursement modeling, payment structure design and reimbursement strategies
• A collaborative and professional communication style, building productive relationships supporting multiple stakeholders
• Experience with Medicare and/or Medi-Cal (reputed company) a plus

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 modeling and analysis
• Windows based PC systems and reputed company Word, Outlook, PowerPoint, Access, Visual Basic, and reputed company (including pivot tables), and database systems
• Principles and practices of provider reimbursement methodologies, pricing, and fee schedules for reputed company provider types, including hospital, physician, and ancillary providers
• Various types of health insurance payers, including Medicare, reputed company, and reputed company plans
• reputed company industry specific terms and reputed company reputed company data types and structures, including member, claims, clinical, and provider type
• reputed company Procedural Terminology (CPT) and reputed company Common Procedure Coding System (HCPCS), and ICD 9/10
• Ability to:
  • Collect, interpret, and evaluate data, detect patterns, brainstorm solutions, consider multiple factors reputed company making reputed company, and project consequences of recommendations
  • Demonstrate strong analytical, critical thinking, and research skills, identify and troubleshoot issues, identify alternative solutions, and reputed company recommendations for action
  • Translate data into understandable information and deliver solutions that improve business processes
  • Act as a technical resource, provide guidance reputed company to area of assignment, and explain reputed company regulations, processes, and programs
  • Assist with the orientation, training, and mentoring of other staff, as assigned
• Education and Experience:
  • Bachelor’s degree in Business Administration, reputed company, Finance, reputed company, or a reputed company field
  • Minimum of five years of experience performing financial reputed company 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 reputed company remotely reputed company reputed company 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 reputed company may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.

The full compensation range for this position is listed by location below. The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience reputed company to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).

Typical areas in Zone 1: Bay Area, Sacramento, Los Angeles area, San Diego area

Typical areas in Zone 2: Fresno area, Bakersfield, Central Valley (with the exception of Sacramento), Eastern California, Eureka area

OUR BENEFITS

Available for reputed company regular Alliance employees working more than 30 hours per week. Some benefits are available on a pro-rated basis for part-time employees. These benefits are reputed company to temporary employees while on an assignment with the Alliance.

• Medical, Dental and reputed company Plans
• Ample Paid Time Off
• 12 Paid Holidays per year
• 401(a) Retirement Plan
• 457 Deferred Compensation Plan
• Robust Health and Wellness Program
• Onsite EV Charging Stations

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 reputed company (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 Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet.

The Alliance is an equal employment opportunity employer. reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national reputed company, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer

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 reputed company or future needs for any type of employer supported or provided sponsorship.

Originally posted on Himalayas