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

• Medical, Dental and Vision Plans
• Amble 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.