Note: The job is a remote job and is open to candidates in USA. Dental Care Alliance is seeking a Payor Pricing Analyst to build, maintain, and optimize financial models supporting payor contract strategy. The role focuses on fee schedule negotiations, reimbursement benchmarking, revenue impact modeling, contract analysis, reporting, and providing actionable insights to leadership.
Responsibilities
- Build and maintain dynamic fee schedule models across UCR, Medicaid, Medicare Advantage and commercial payor contracts
- Develop multi-scenario revenue impact models to evaluate proposed fee changes and network participation decisions
- Create annual reimbursement benchmarking analyses comparing contracted rates to FAIR Health, ADA fee surveys, and internal production data
- Prepare negotiation briefs with modeled rate ask scenarios, walk-away thresholds, and estimated uplift
- Track contract lifecycles, renewal timelines, and amendment history across all payor relationships
- Support leadership with data packages for payor meetings, including trend analyses and competitive positioning
- Serve as the primary liaison between Fee Schedule and Payor Pricing teams, ensuring timely and accurate communication of effective dates, fee updates, and new schedule implementations
- Develop ad hoc models for executive decision-making including payor mix optimization and pricing strategy
Skills
- The role requires sustained computer and desk work with prolonged sitting, regular virtual communication, and occasional light lifting of typical home-office items
- Ability to analyze reimbursement data, build financial models, and assess the revenue impact of payor contract changes
- Knowledge of dental insurance reimbursement methodologies, fee schedules, and contract structures
- Skilled at interpreting large datasets, identifying trends, and translating findings into actionable business insights
- Evaluates financial opportunities and risks to support contract negotiations and reimbursement optimization efforts
- Investigates reimbursement variances, identifies root causes, and develops effective solutions
- Clearly presents complex financial information and collaborates effectively with cross-functional stakeholders
- Ensures accuracy in financial models, fee schedules, contract analysis, and reporting
- Builds strong partnerships across Revenue Cycle, Finance, Operations, Credentialing, and Leadership teams
- Understands how reimbursement strategies impact organizational performance and profitability
- Demonstrates initiative in enhancing processes, reporting, and reimbursement performance while taking ownership of results
- High School Diploma or Equivalent Required
- 3+ years of experience in dental revenue cycle, payor contracting, or healthcare financial analysis
- Advanced Excel proficiency: financial modeling, pivot tables, VLOOKUP/INDEX-MATCH, scenario analysis, dynamic dashboards
- Experience analyzing fee schedules data at scale
- Demonstrated ability to build models that drive business decisions — not just report data
- Strong written and verbal communication skills; able to present analytical findings to leadership
Benefits
- Fully remote work in a home-based professional setting with substantial digital collaboration
Company Overview