Payer Analytics Consultant
Skills
- Advanced Excel modeling (pivot tables, formulas, VBA familiar)
- Experience with SQL for data extraction and manipulation
- Familiarity with data visualization tools such as Tableau
- Strong understanding of provider reimbursement methodologies (fee-for-service, value-based, risk-sharing)
- Ability to interpret claims, member, clinical, and provider data
- Clear written and verbal communication for cross-functional audiences
- Analytical mindset with attention to detail and scenario planning
Responsibilities
- Design, build, validate, and document managed care payer financial and reimbursement models
- Perform moderately complex financial and scenario analyses to evaluate payer reimbursement methodologies and feasibility
- Produce data-driven recommendations to support negotiation and implementation of payment methodologies
- Coordinate and collaborate with internal teams (finance, provider network, operations, clinical) and external partners to achieve payer reimbursement objectives
- Translate analysis into clear presentations and deliverables for technical and non-technical stakeholders
- Maintain and improve data quality, modeling processes, and reporting workflows
Education
- Bachelor’s degree in Business, Accounting, Finance, Healthcare, or related field (required)
- Master’s degree may substitute for two years of required experience (preferred)
Benefits
- Medical, dental, and vision plans
- Ample paid time off and 12 paid holidays per year
- 401(a) retirement plan and 457 deferred compensation plan
- Robust health and wellness program
- Onsite EV charging stations
- Hybrid work environment with remote options and occasional in-person/quarterly events
Average salary estimate
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