We have an opportunity to join the Alliance as a Senior Payer Analytics Consultant in the Payment Strategy team.
This is a fully remote position and can be filled anywhere within California.
WHAT YOU'LL BE RESPONSIBLE FOR
- Performing complex managed care payer financial modeling and analysis to evaluate the feasibility of payer reimbursement methodologies
- Conducting complex financial analysis to support successful payer reimbursement outcomes
- Coordinating and collaborating with internal and external stakeholders to achieve payer reimbursement objectives
- Providing subject matter expertise and assisting with providing orientation, mentoring, and training to subordinate Payer Analytics Consultants
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 INFORMATION
- We are in a hybrid work environment, and we anticipate that the interview process will take place remotely via Microsoft 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 presence 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 related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).
OUR 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
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 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. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, 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 current or future needs for any type of employer supported or provided sponsorship.
