Payer Analytics Consultant (Defined Term)

About the role

The Payer Analytics Consultant (Defined Term) position is designated by the Alliance and is a position of limited duration. Defined Term employees are usually hired to work in a specific department on specific long-term project work until the work is completed or to a specific end date not to exceed December 31, 2026. This Defined Term role is a fully benefited position. This position can be filled within any of our Alliance service areas, or remotely within the Pacific, Mountain and Central time zones.

Responsibilities

• 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
• Collaborates with internal and external stakeholders to achieve payer reimbursement objectives

Requirements

• 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

Qualifications

• Bachelor’s degree in Business Administration, Accounting, Finance, Healthcare, or a related field
• A minimum of three years of experience performing financial healthcare reimbursement analysis (a Master’s degree may substitute for two years of the required experience)

Skills

• Knowledge of Windows based PC systems and Microsoft Word, Outlook, PowerPoint, Access, Visual Basic, and Excel (including pivot tables), and database systems
• Methods and techniques of financial modeling and analysis
• Principles and practices of provider reimbursement methodologies, pricing, and fee schedules for all provider types, including hospital, physician, and ancillary providers
• Healthcare industry specific terms and healthcare related data types and structures, including member, claims, clinical, and provider types
• National standards for fee-for-service and value-based provider reimbursement methodologies, including risk-sharing models
• Data modeling techniques and business analytical and data mining tools, including SQL, and data visualization tools, such as Tableau

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 Plans
• Ambitious Paid Time Off
• 12 Paid Holidays per year
• 401(a) Retirement Plan
• 457 Deferred Compensation Plan
• RoBust Health and Wellness Program
• Onsite EV Charging Stations

Pay

Compensation Information
Zone 1 Pay Range: $125,000 - $140,000
Typical areas in Zone 1: Santa Cruz, San Benito, and Monterey Counties, Bay Area, Sacramento, Los Angeles and San Diego areas
Zone 2 Pay Range: $118,000 - $132,000
Typical areas in Zone 2: Mariposa and Merced Counties, Fresno area, Bakersfield, Eastern California, San Luis Obispo area, and the Central Valley (except Sacramento)

Schedule

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.