[Hiring] Payer Analytics Consultant @Central California Alliance for Health (Remote)

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description We have an opportunity to join the Alliance as a Payer Analytics Consultant in the Payment Strategy Department. There are two positions that can be filled as a Payer Analytics Consultant or Senior Payer Analytics Consultant level. This position can be filled remotely for those living in California. Reporting to the Payment Strategy Director, this position: • 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 Qualifications • 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 Requirements 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 Benefits • Medical, Dental and Vision 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 • And many more Apply tot his job Apply To this Job