Payor Pricing Analyst

Responsibilities

• Build and maintain dynamic fee schedule models across UCR, Medicaid, Medicare Advantage and commercial payor contracts
• Create multi-scenario revenue impact models to evaluate proposed fee changes and network participation decisions
• Develop 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
• 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
• Work with data infrastructure and reporting to support executive-level decision-making

Qualifications

• High School Diploma or Equivalent
• 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
• 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