Support the development, validation, and optimization of provider reimbursement strategies through advanced data analysis
Evaluate provider payment methodologies, conduct contract repricing analyses, and deliver actionable insights
Perform contract repricing analyses using claims data to assess financial impact of proposed rate and contract changes
Analyze key financial metrics, including billed charges, allowed amounts, units, and utilization trends
Support benchmarking of provider reimbursement rates against applicable Medicare, Medicaid, and commercial benchmarks
Utilize SQL, Python, and business intelligence tools to analyze large, complex healthcare datasets
Leverage automation and AI-assisted tools to improve efficiency in data processing, variance identification, and reporting
Perform scenario modeling to evaluate the financial and operational implications of alternative reimbursement structures
Collaborate with various teams to support rate development and network strategy initiatives

Bachelor's degree in Healthcare Administration, Data Analytics, Finance, Economics or related field required
Equivalent years of relevant work experience may be accepted in lieu of required education
Two (2) years of experience in healthcare reimbursement, provider contracting or claims data analysis required
Experience working with healthcare claims data and reimbursement methodologies required
Experience with data analytics tools, automation, or AI enabled technologies preferred

Provider Contracting Analyst II

Key skills