We have an opportunity to join the Alliance as a Payer Analytics Consultant in the Payment Strategy Department. There are two positions that can be filled as a Payer Analytics Consultant or Senior Payer Analytics Consultant level.
This position can be filled remotely for those living in California.
WHAT YOU'LL BE RESPONSIBLE FOR
Reporting to the Payment Strategy Director, this position :
- Designs and validates managed care payer models and performs moderately complex analysis to evaluate the feasibility of payer reimbursement methodologies
- Conducts moderately complex financial analysis to support successful payer reimbursement outcomes
- Coordinates and collaborates with internal and external stakeholders to achieve payer reimbursement objectives
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
Technically strong, with proven experience in payer financial modeling, provider payment methodologies, payment structure design, and reimbursement strategy development.Analytical and detail-oriented, skilled in data interpretation, trend analysis, and scenario modeling to inform decision-making and optimize payment accuracy.Collaborative and solutions-focused, working effectively across departments - including finance, provider network management, operations, and clinical teams - to align analytics with business goals.A clear and professional communicator, able to explain complex financial and analytical concepts to both technical and non-technical audiences.Relationship-driven, fostering productive partnerships with internal stakeholders and external partners to support shared priorities and ensure alignment.Curious and improvement-minded, continuously seeking opportunities to enhance data quality, streamline processes, and support innovative payment strategies.WHAT YOU'LL NEED TO BE SUCCESSFUL
To read the full position description and list of requirements, click here .
Knowledge of :Windows based PC systems and Microsoft Word, Outlook, PowerPoint, Access, Visual Basic, and Excel (including pivot tables), and database systemsMethods and techniques of financial modeling and analysisPrinciples and practices of provider reimbursement methodologies, pricing, and fee schedules for all provider types, including hospital, physician, and ancillary providersHealthcare industry specific terms and healthcare related data types and structures, including member, claims, clinical, and provider typesNational standards for fee-for-service and value-based provider reimbursement methodologies, including risk-sharing modelsData modeling techniques and business analytical and data mining tools, including SQL, and data visualization tools, such as TableauAbility to :
Collect, interpret, and evaluate data, detect patterns, brainstorm solutions, consider multiple factors when making decisions, and project consequences of recommendationsDemonstrate strong analytical, critical thinking, and research skills, identify and troubleshoot issues, identify alternative solutions, and make recommendations for actionTranslate data into understandable information and deliver solutions that improve business processesAct as a technical resource, provide guidance related to area of assignment, and explain related regulations, processes, and programsInterpret and apply rules, regulations, policies, procedures, and guidesWork collaboratively with individuals at all levels of the organization while supporting multiple stakeholdersEducation and Experience :
Bachelor's degree in Business Administration, Accounting, Finance, Healthcare, or a related fieldA minimum of three 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 qualifyingOTHER 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.The full compensation range for this position is listed by location below.
The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).
Typical areas in Zone 1 : Bay Area, Sacramento, Los Angeles area, San Diego area
Typical areas in Zone 2 : Fresno area, Bakersfield, Central Valley (with the exception of Sacramento), Eastern California, Eureka area
Zone 1 (Monterey, San Benito and Santa Cruz)
$97,920 — $156,686 USD
Zone 2 (Mariposa and Merced)
$89,108 — $142,584 USD
OUR BENEFITS
Available for all regular Alliance employees working more than 30 hours per week.Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance.
Medical, Dental and Vision PlansAmple Paid Time Off12 Paid Holidays per year401(a) Retirement Plan457 Deferred Compensation PlanRobust Health and Wellness ProgramOnsite EV Charging StationsABOUT US
We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.
Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet .
The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer
At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.