Senior Healthcare Strategy & Contracts Analyst | South Portland, Maine

The ideal candidate blends technical expertise with strong communication and influencing skills to align diverse stakeholders and advance organizational success in a rapidly evolving healthcare landscape.

CORE RESPONSIBILITIES :

• Lead the development and execution of value-based contracting strategies in partnership with contracting, revenue cycle, value-based care, and clinical leadership, leveraging advanced analytics and data science to drive enterprise-wide results.
• Serve as a strategic advisor to the contract negotiations team, providing forward-looking analysis of historical and projected performance, and delivering actionable insights on contract proposals and counterproposals.
• Partner with the Value-Based Care Team to evaluate clinical performance and risk adjustment data across commercial and government payer models, identifying opportunities to optimize outcomes and inform future contracting strategies.
• Design and enhance supplemental payer data feeds to maximize clinical performance reporting and ensure accurate capture of all risk-adjustable conditions.
• Analyze reimbursement trends and variances by payer and contract, providing recommendations to senior leadership to inform strategic decision-making.
• Develop and maintain advanced forecasting methodologies for non-fee-for-service payments, including PMPM, quality incentives, and shared savings, ensuring accurate financial projections.
• Build, refine, and oversee predictive models to evaluate contract performance, identify improvement opportunities, and support strategic initiatives.
• Review and validate payer financial settlements, reconciling interim and year-end reports against clinical and operational performance, and advising leadership on resolution of discrepancies.
• Deliver executive-level insights and reporting on payer performance, profitability, and emerging risks to support strategic decision-making.
• Lead cross-functional solutions with Contracting, Finance, and Revenue Cycle teams to address complex reimbursement issues and implement sustainable solutions.
• Assess the impact of new payer policies, regulations, and programs, providing guidance to leadership on potential effects on reimbursement and operational performance.
• Maintain subject matter expertise on industry trends, reimbursement models, and payer policies, serving as a thought partner to executive and clinical leadership.
• Maintains strict confidentiality in alignment with HIPAA (Health Insurance Portability and Accountability) guidelines and InterMed policies.
• Perform other duties to support the mission, vision and values of InterMed.

MISSION AND VALUES :

KNOWLEDGE, SKILLS, AND ABILITIES :

5-7+ years of progressive healthcare experience, particularly in payer contracting, value-based care strategy, or healthcare finance, with demonstrated strategic responsibility.

Leadership / Strategic Influence : Proven experience leading cross-functional initiatives across multiple departments and influencing executive-level decision-making to drive organizational strategy.

N / A

Equal Opportunity Employer

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