Payer Strategy & Revenue Cycle Analyst

Payer Strategy & Revenue Cycle Analyst

Our Payer Strategy & Revenue Cycle Analyst will play a key role in advancing BlueSprig's financial performance by providing insights into payer contracts, reimbursement rates, and cash collections. This individual will collaborate closely with our Payer Strategy and Revenue Cycle Management (RCM) teams to ensure efficient revenue capture and support data-driven contract negotiations with health plans and payers.

Responsibilities

Job Duties and Responsibilities include the following. Other duties may be assigned.

• Analyze and model impact of reimbursement rates across payers to support contract negotiations and financial forecasting.
• Analyze key volume and quality data to model value delivered to clients and payers to support contract negotiations
• Build and maintain models to evaluate the financial impact of current and prospective payer agreements.
• Partner with RCM leadership to track and improve cash collections, payment trends, and denial resolution. Support development of dashboards that can rapidly identify issues
• Develop reports and dashboards that track KPIs such as reimbursement rates, days sales outstanding (DSO), denial rates, and payer performance.
• Provide detailed insights into underpayments, payment variances, and opportunities for improved revenue capture.
• Collaborate with clinical, credentialing and operations teams to understand service delivery data and align payer analytics accordingly.
• Assist with forecasting and budgeting efforts related to payer mix, revenue, and expected collections.
• Present complex data findings in a clear, concise manner to both technical and non-technical stakeholders.

Qualifications

Education / Experience : Bachelor's degree in Healthcare Administration, Finance, Economics, Data Analytics, or a related field (Master's preferred). 25 years of experience in healthcare payer / RCM analytics, preferably within a provider or behavioral health environment. Solid understanding of payer contract structures, healthcare reimbursement methodologies, and RCM principles. Knowledge of payer networks, value-based reimbursement models, and state Medicaid programs. Familiarity with CPT coding, claims data analysis, and managed care payment models. Experience working with pediatric therapy services, ABA therapy, or behavioral health providers.