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

Requirements

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
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

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

financial analysisfinancial modelingdata modelingdata analysisdata miningreimbursement methodologiesrisk-sharing modelspivot tablesSQLdata visualization

Soft Skills

analytical skillscritical thinkingresearch skillsproblem-solvingcollaborationcommunicationdecision-makinginterpretation of datasolution deliverystakeholder management