Talent.com
Lead Payer Analytics Consultant
Lead Payer Analytics ConsultantASSOCIATION FOR COMMUNITY AFFILIATED PLANS • Washington, DC, United States
No longer accepting applications
Lead Payer Analytics Consultant

Lead Payer Analytics Consultant

ASSOCIATION FOR COMMUNITY AFFILIATED PLANS • Washington, DC, United States
30+ days ago
Job type
  • Full-time
Job description

Overview

We have an opportunity to join the Alliance as a Lead Payer Analytics Consultant in the Payment Strategy Department. There are two positions that can be filled remotely for those living in California.

Responsibilities

  • Functions as a strategic consultant to Alliance executive leadership in the areas of complex managed care payer financial modeling and statistical analysis to evaluate the feasibility of payer reimbursement methodologies
  • Advises Alliance executive leadership on organizational decision making through the performance of complex financial analysis to support successful payer reimbursement outcomes
  • Acts as subject matter expert and collaborates with internal and external stakeholders to achieve payer reimbursement objectives
  • Acts as a subject matter expert and lead to subordinate staff

About the Team

The Payment Strategy department ensures the Alliance’s payments to our network are adequate to our revenue. We also work to advance our payment methodology in order to achieve the best quality healthcare while reducing costs.

The Ideal Candidate

  • An experienced analytical and collaborative lead, with direct experience with complex medical payor modeling
  • Technically strong, with skill in provider reimbursement modeling, payment structure design and reimbursement strategies
  • A collaborative and professional communication style, building productive relationships supporting multiple stakeholders
  • Experience with Medicare and / or Medi-Cal (Medicaid) a plus
  • What You’ll Need to Be Successful

    To read the full position description, and list of requirements please view the attached link.

  • Knowledge of :
  • 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
  • Healthcare financial statements and accounting principles
  • Methods and techniques of developing and delivering data management strategies that support contract analysis, trend management, budgeting, forecasting, strategic planning, and healthcare operations
  • National standards for fee-for-service and value-based provider reimbursement methodologies, including risk-sharing models
  • Ability to :
  • Demonstrate strong analytical, critical thinking, and research skills, identify and troubleshoot issues, identify alternative solutions, and make recommendations for action

  • Be a technical resource, provide guidance related to area of assignment, and explain related regulations, processes, and programs
  • Lead, train, mentor and motivate staff, and promote an atmosphere of teamwork and cooperation
  • Produce organized, accurate, and detail-oriented work in a fast-paced environment and under the pressure of deadlines
  • Education and Experience

    Bachelor’s degree in Business Administration, Accounting, Finance, Healthcare, or a related field

    A minimum of eight 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.

    #J-18808-Ljbffr

    Create a job alert for this search

    Consultant • Washington, DC, United States

    Related jobs
    Lead Solutions Consulting – Cybersecurity

    Lead Solutions Consulting – Cybersecurity

    Palo Alto Networks • Washington, District Of Columbia, United States
    Full-time
    A leading cybersecurity company is seeking a Solutions Consultant Manager in Washington, DC.In this role, you will lead a team to provide guidance on security solutions, ensuring client satisfactio...Show more
    Last updated: 3 days ago • Promoted
    Data Analytics Team Lead

    Data Analytics Team Lead

    TeleSolv Consulting • Washington, District of Columbia, United States, District of Columbia, US
    Full-time
    Quick Apply
    TeleSolv Consulting has an immediate opportunity to work with the Federal Government as a Mid-Sr.Federal Government Agency experience for a client of ours. This person will be required to work on-si...Show more
    Last updated: 11 days ago
    Lead Analyst

    Lead Analyst

    Technomics • Arlington, VA, United States
    Full-time
    Technomics is a growing employee-owned, decision analytics company that specializes in cost and economic analysis to facilitate. We enable a wide range of clients across the Federal government, from...Show more
    Last updated: 30+ days ago • Promoted
    Value Based Platform - Portfolio Planning Lead

    Value Based Platform - Portfolio Planning Lead

    Risant Health • Washington, DC, United States
    Full-time
    This position is hybrid, requiring onsite presence in Washington, DC or Seattle, WA approximately 2-3 days per week.Risant Health, a nonprofit affiliate of Kaiser Foundation Hospitals, is transform...Show more
    Last updated: 6 days ago • Promoted
    Senior Market Access & Payer Strategy Lead

    Senior Market Access & Payer Strategy Lead

    Millennium Health, LLC. • Washington, DC, United States
    Full-time
    A leading healthcare company in Washington D.Director of Market Access Operations to manage relationships with payers and drive revenue growth. Responsibilities include analyzing payer contracts, co...Show more
    Last updated: 5 days ago • Promoted
    Lead FOIA Analyst

    Lead FOIA Analyst

    Wits Solutions Inc • Arlington, VA, United States
    Full-time
    Quick Apply
    WITS) is a SBA certified 8(a) company with headquarters in the metropolitan Washington D.WITS has been providing best-in-class solutions in professional IT and administrative consulting to various ...Show more
    Last updated: 30+ days ago
    Strategy Consultant - Cross-Border Payments

    Strategy Consultant - Cross-Border Payments

    FXC Intel • Washington, DC, United States
    Full-time
    Strategy Consultant - Cross-Border Payments.We are looking for a Strategy Consultant - Cross-Border Payments to join FXC Intelligence, allowing us to expand our strategic advisory offering for ente...Show more
    Last updated: 20 days ago • Promoted
    BI Enablement & Analytics Lead

    BI Enablement & Analytics Lead

    Software Technology Inc • Washington, DC, United States
    Full-time
    Quick Apply
    We are seeking a strategic and hands-on BI Enablement & Analytics Lead to drive the adoption of data-driven decision-making across our organization. Sitting at the intersection of technical deve...Show more
    Last updated: 3 days ago
    Head of Data Strategy & Analytics — Banking Insights Leader

    Head of Data Strategy & Analytics — Banking Insights Leader

    EagleBank • Bethesda, MD, United States
    Full-time
    A financial services company in Bethesda, Maryland is seeking a Director of Data Strategy and Analytics.This role involves leading a team to enhance data solutions and reporting strategies.The idea...Show more
    Last updated: 12 days ago • Promoted
    Lead Analyst - Google Analytics Implementation

    Lead Analyst - Google Analytics Implementation

    Blend360 • Columbia, MD, United States
    Full-time
    Blend360 is a world class marketing, analytics, and technology company that delivers the best results for our clients.Our primary focus is Data Sciences. leveraging data and applied mathematics to ...Show more
    Last updated: 30+ days ago • Promoted
    Lead Analyst, Performance Analytics

    Lead Analyst, Performance Analytics

    Evolent • Washington, DC, United States
    Full-time
    Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect...Show more
    Last updated: 21 days ago • Promoted
    Managing Consultant - Healthcare Analytics

    Managing Consultant - Healthcare Analytics

    BRG • Washington, DC, United States
    Full-time
    Managing Consultant - Healthcare Analytics.Managing Consultant - Healthcare Analytics.BRG currently has over 40 offices across the United States and internationally. This position can be located in ...Show more
    Last updated: 30+ days ago • Promoted
    Value Realization Lead — KPI & Impact Analytics

    Value Realization Lead — KPI & Impact Analytics

    IBM • Washington, DC, United States
    Full-time
    A leading global technology company is seeking a Senior Strategy Consultant in Washington, DC.The role focuses on operationalizing value frameworks, managing performance measurement for key program...Show more
    Last updated: 10 days ago • Promoted
    Director, Data Analytics Consulting

    Director, Data Analytics Consulting

    Control Risks • Washington, DC, US
    Full-time
    Quick Apply
    This role may be based in Washington DC, San Francisco, Houston, or Chicago.Someone ready to help shape the next stage of Control Risks’ Data Analytics journey in the Americas.If you thrive in entr...Show more
    Last updated: 30+ days ago
    Senior Data Architect — Secure Data & Analytics Leader

    Senior Data Architect — Secure Data & Analytics Leader

    ExecutivePlacements.com • Washington, District Of Columbia, United States
    Full-time
    A leading recruitment firm is looking for a Data Architect to design and manage data architecture frameworks supporting innovative data systems. The ideal candidate will have over 10 years of experi...Show more
    Last updated: 2 days ago • Promoted
    Lead Senior Credit Modeling & Risk Analytics (Hybrid)

    Lead Senior Credit Modeling & Risk Analytics (Hybrid)

    M&T Bank • Washington, DC, United States
    Full-time
    A leading banking institution seeks a Manager of Quantitative Analysis in Washington, DC.This role involves managing a team focused on quantitative behavioral modeling, guiding the development and ...Show more
    Last updated: 5 days ago • Promoted
    Procure to Pay (P2P) Functional Analyst

    Procure to Pay (P2P) Functional Analyst

    Accenture Federal Services • Washington, DC, United States
    Full-time
    At Accenture Federal Services, nothing matters more than helping the US federal government make the nation stronger and safer and life better for people. Our 13,000+ people are united in a shared pu...Show more
    Last updated: 10 days ago • Promoted
    Digital Sales Consultant

    Digital Sales Consultant

    SureGuard • Alexandria, VA, US
    Full-time
    Quick Apply
    Chart Your Success Path with Our Elite Sales Team! Recognized for our exceptional workplace culture by Entrepreneur Magazine and highly rated on Glassdoor and Indeed, we've also been s...Show more
    Last updated: 30+ days ago