Note: The job is a remote job and is open to candidates in USA. Scripps Health is a healthcare organization seeking a Senior Payer Contracting Data Analyst to support its Payer Relations team. The role transforms payer data into actionable insights, develops reimbursement models and financial proposals, and supports the negotiation, monitoring, and optimization of payer contracts and relationships.
Responsibilities
- Responsible for transforming complex payer data into actionable insights that drive smarter contract decisions
- Analyze complex data sets, proactively explore insights, and clearly communicate findings to both clinical and operational stakeholders
- Lead cross functional efforts across finance, strategy, and health system performance, to effectively negotiate, monitor, and optimize payer relationships
- Provide the analytical foundation for strategic growth, lead reimbursement modeling, trend analysis, financial proposal development, contract term optimization, risk assessment, and payer performance audits
- Direct business analysis for new and renewing payer contract negotiations, maintain payer contract portfolio reporting, and serve as a key partner to revenue cycle and other internal teams
Skills
- Bachelor's degree in business, math or health administration
- 3 years broad-base healthcare experience with knowledge of healthcare products and services knowledge
- Expert knowledge of Microsoft Excel, SQL and data manipulation
- Excellent communication skills and exceptional relationship-building skills
- Strong SQL and data manipulation skills, Detail-oriented with strong analytical abilities
- Ability to work both independently and as part of a team
- Strategic and critical thinking skills
- Strong problem-solving skills and the ability to adapt
- Master's degree in business, health administration, math or statistics preferred
- Knowledge and understanding of EPIC, Business Intelligence reporting technologies, and data mart technologies and principles
- Strong understanding of healthcare payer systems, reimbursement models, and insurance policies
- Knowledge of CPT, HCPCS, ICD-10, facility revenue codes and healthcare claims data; experience with billing/payment systems
- Experience maintaining expected reimbursement in contract management systems (e.g., EPIC)
- Ability to analyze data and make data-driven decisions
- Knowledge of healthcare regulations and compliance standards
- Proficiency in Strata Axiom contract management software and Epic EHR, including Cogito - Slicer Dicer
Benefits
- Full time, benefited, salaried role
- Work-from-home
- Transitional and professional development programs
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