Payor Relations Analyst

About the role

Metro Vein Centers is a rapidly growing healthcare practice specializing in state-of-the-art vein treatments. Our board-certified physicians and expert staff are on a mission to improve people’s quality of life by relieving the painful, yet highly treatable symptoms of vein disease—such as varicose veins and heavy, aching legs. With over 70 clinics across 8 states, we’re building the future of vein care—delivering compassionate, results-driven care in a modern, patient-first environment.

We are looking for a strong finance or accounting foundation paired with hands-on provider reimbursement analysis, financial modeling, and contract analysis in a managed care environment. You will turn contracts, fee schedules, and high-volume claims data into financial intelligence: modeling reimbursement, quantifying rate changes, isolating underpayments and denial patterns, and arming leadership with the numbers to negotiate from strength across 9 states.

Responsibilities

• Financial analysis & modeling
  • Build multi-layered models forecasting the revenue impact of proposed rate adjustments, fee schedule changes, and alternative payment models (fee-for-service, capitation, value-based care, risk-sharing).
  • Evaluate proposed rates from payors using historical utilization and claims data to project net revenue impact by market, service line, and payor.
  • Analyze payor contracts, reimbursement methodologies, and financial performance across commercial, Medicare Advantage, and Managed Medicaid books of business.
  • Interpret financial and reimbursement reports, build scenario and sensitivity analyses, and deliver actionable recommendations to leadership.
• Contract performance & reimbursement integrity
  • Track overall yield across commercial, Medicare Advantage, and Managed Medicaid plans to ensure payors reimburse according to executed agreements.
  • Isolate underpayments, payment variances, and contract non-compliance by analyzing claim outcomes against expected contractual terms, then quantify the exposure and drive recovery.
  • Maintain and audit contract configuration, fee schedules, and reimbursement matrices in the EHR/practice management and RCM systems with rigorous accuracy and version control.
  • Track contract expiration and escalator timelines so negotiation strategy begins well ahead of every deadline.
• Contract negotiation support
  • Partner with Payor Relations leadership to evaluate proposed reimbursement structures and build the financial case behind every ask.
  • Quantify the impact of new contracts, amendments, renewals, and reimbursement changes before and after execution.
  • Support internal stakeholders throughout the contracting lifecycle, from initial modeling through post-signature validation.
• Reporting, dashboards & executive communication
  • Synthesize high-volume claims data, denial trends, and payment metrics into dashboards, briefing packets, and scenario analyses for the Senior Manager and Director, tracking payor mix, weighted-average rate increases, and contract timelines.
  • Explain complex financial findings to business leaders clearly and connect the numbers to the decision in front of them.
  • Own the accuracy of every analysis, including source data validation and reconciliation to system of record.
• Payor relationship management & operations
  • Serve as an operational point of contact for provider relations representatives across assigned health plans, resolving systemic claim issues and administrative friction.
  • Prepare analytical agendas and performance data packets, and track actionable follow-ups for recurring Joint Operating Committee (JOC) meetings with health plan representatives.
  • Partner with Patient Access, Billing, Coding, and Denial Management on root-cause analysis of recurring rejections, then establish process changes that prevent them from returning.
  • Monitor administrative updates, medical coverage policy changes, and pre-authorization requirements; communicate operational impact to RCM, Billing, and Clinical teams as we scale into new markets.
• Cross-functional collaboration
  • Collaborate with Finance, Credentialing, RCM, Billing, and Operations to translate financial data into strategic recommendations.
  • Identify opportunities to improve financial performance, reimbursement strategy, and operational efficiency across the organization.

Requirements

• Education & healthcare experience
  • Bachelor's degree in Finance, Accounting, Economics, Healthcare Administration, Business Analytics, Health Information Management, or a related field, or equivalent practical experience.
  • 3-5+ years of progressive healthcare financial analysis experience in provider reimbursement, payor relations, managed care, revenue cycle analysis, or healthcare financial/business analytics. Healthcare experience is required.
  • Provider, MSO, or multi-state specialty group experience preferred; health plan, MCO, or payer-side reimbursement experience also considered.
  • Strong finance or accounting foundation with demonstrated ability to interpret financial statements, reimbursement reports, and contract economics.
  • Demonstrated experience performing financial modeling, provider reimbursement analysis, and provider contract financial analysis.
  • Experience supporting contract negotiations through financial analysis and modeling.
  • Strong working knowledge of reimbursement methodologies (fee-for-service, capitation, value-based care), coding standards (CPT, ICD-10, HCPCS), and revenue cycle workflows.
  • In-depth understanding of commercial payor structures, Medicare Advantage, and Medicaid fee-for-service and managed care variations across states.
• Technical & analytical proficiency
  • Advanced Excel (required) – complex data manipulation with dynamic functions, pivot tables, nested logic, financial modeling, forecasting, and scenario analysis.
  • Business intelligence & querying (preferred) – SQL, Power BI, or Tableau used to analyze healthcare claims and financial datasets and build dashboards. SQL is strongly preferred.
  • Experience with major EHR/billing software and health plan portals (Availity, CAQH).
  • Able to explain financial data to business leaders in clear, decision-ready terms.
• Preferred
  • Experience in a rapidly growing MSO, specialty medical group, ASC, or multi-state provider environment.
  • Contract-modeling and analytics platforms such as Rivet; familiarity with multi-state credentialing and enrollment.
  • Knowledge of value-based care, risk arrangements, and payor quality programs.
• Core Competencies
  • Analytical rigor – you reason from the data, pressure-test your own numbers, and can defend every figure you put in front of leadership.
  • Business acumen – you connect quantitative findings to real healthcare operations, clinical workflows, and revenue cycle impact.
  • Upward communication – you package complex datasets and contract terms into straightforward summaries for senior leadership.
  • Proactive problem-solving – a self-starter who finds root causes and drives resolution with internal teams and external payors alike.
  • Precision & ownership – accuracy is non-negotiable, and you juggle multiple projects and analysis at once.

Benefits

• Medical, Dental, and Vision Insurance
• 401(k)
• Paid Time Off (PTO) + Paid Company Holidays
• Company-Paid Life Insurance
• Short-Term Disability Insurance
• Employee Assistance Program (EAP)
• Career Growth & Development Opportunities

About Metro Vein Centers

The Metro Vein Centers Difference

Healthy legs. Happier lives. At Metro Vein Centers, we believe exceptional care begins with an exceptional experience. Our mission is to make vein care approachable, empowering, and connected to overall well-being. From the first conversation to the final follow-up, every patient interaction reflects our commitment to compassion, expertise, and trust.

A team united by purpose. Our values guide everything we do:

• Patients First, Always – Every interaction should make our patients feel valued, heard, and cared for.
• Stronger Together – Teamwork and collaboration drive our success. We lift each other up to deliver the best for our patients.
• A Can-Do Spirit – We meet every challenge with positivity, flexibility, and problem-solving energy.
• Results That Make a Difference – We’re driven to improve lives through meaningful, measurable outcomes.
• Commitment to Growth – We invest in our people, fostering advancement and professional development at every level.