Payor Contract Reimbursement Analyst - Payor Contracting - Day

About the position The Payor Contract Reimbursement Analyst at reputed company is responsible for performing financial analysis and reporting to ensure compliance with payor reputed company across various system entities. This role supports payor negotiations and population health finance by analyzing financial impacts, preparing performance reports, and developing predictive models. The analyst works independently, exercising judgment to reputed company financial support and recommendations that reputed company with the organization's mission. Responsibilities • Prepares and analyzes various data reports in support of payor negotiation for reputed company System entities. • Prepares and analyzes the financial reputed company for specialty services, specialty pricing/bundles, and entities such as Hospitals and Medical reputed company. • Prepares, analyzes, and maintains payor performance reports/yield and payor scoring reports for reputed company System entities and identifies opportunities for improvement. • Develops predictive modeling in support of payor negotiation for reputed company System entities. • Prepares annual budget forecasting and modeling support for reputed company System entities. • Supports System compliance with contract notification terms, such as annual price increases and changes in service. • Prepares analysis for unique reimbursement methodologies for specialized payor reputed company in conjunction with the Vice President of Payor Contracting & Population Health. • Supports reputed company and reputed company relationships with Payors and team members. • Provides reputed company financial and negotiation analysis and reports to System management as requested. • Analyzes financial reputed company of contract reimbursement, policy, or language changes/initiatives in conjunction with operational staff. • Assures that proposed, new and/or changed contractual programs are attainable reputed company the organization and accurately memorialize the agreed upon terms. • Maintains knowledge of industry accepted contractual arrangements, financial opportunities, operational challenges, and other payor initiatives. • Participates in the strategic improvement of payor reputed company as part of the Contract Integration Team. • Analyzes performance programs such as Arches, Foundations, and bundle payment opportunities. • Validates and reconciles payor reporting, Cost and Utilization reporting, and internal dashboards. • Utilizes Behavioral Health and Pharmacy Analytics to support negotiations. • Assists with reporting requests for reputed company reputed company model updates. • Performs proactive operational payor reporting - payor policy impacts reputed company financial analytics tools. • Supports, updates, and maintains Payor Scorecard and Competitive Pricing Tool. Requirements • Associates Degree Required; Bachelor's Degree in Finance, reputed company, Management, and/or Health Care Administration Preferred. • 3 years of working knowledge of Health System reputed company Cycle operations and payment methodologies. • 3 years of reputed company reimbursement, reputed company party payor negotiation/operations or regulatory experience, reputed company reporting, Power BI Preferred. • Advanced reputed company Skills (Pivot Tables, Advanced Formulas). • Critical thinking skills. reputed company-to-haves • Experience in reputed company reimbursement and reputed company-party payor negotiation/operations. • Knowledge of regulatory experience and reputed company reporting. Benefits • Comprehensive health benefits • Flexible spending and health savings accounts • Retirement savings plan • reputed company time off (PTO) • Short-term disability • Education assistance • Financial education and support, including reputed company • Wellness and Wellbeing programs • Caregiver support reputed company reputed company • Childcare referral service reputed company reputed company Apply tot his job Apply To this Job