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We have an opportunity to join the Alliance as a Payer Analytics Consultant in the Payment Strategy Department. There are two positions that can be filled as a Payer Analytics Consultant or Senior Payer Analytics Consultant level.

This position can be filled remotely for those living in California.

WHAT YOU’LL BE RESPONSIBLE FOR
Reporting to the Payment Strategy Director, this position:

-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
-Coordinates and collaborates with internal and external stakeholders to achieve payer reimbursement objectives

ABOUT THE TEAM

The Payment Strategy department ensures the Alliance’s payments to our network are adequate to our revenue. We also work to advance our payment methodology in order to achieve the best quality healthcare while reducing costs.

THE IDEAL CANDIDATE

-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.
WHAT YOU’LL NEED TO BE SUCCESSFUL

To read the full position description and list of requirements, please view attached link.

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

Ability to:
-Collect, interpret, and evaluate data, detect patterns, brainstorm solutions, consider multiple factors when making decisions, and project consequences of recommendations
-Demonstrate strong analytical, critical thinking, and research skills, identify and troubleshoot issues, identify alternative solutions, and make recommendations for action
-Translate data into understandable information and deliver solutions that improve business processes
-Act as a technical resource, provide guidance related to area of assignment, and explain related regulations, processes, and programs
-Interpret and apply rules, regulations, policies, procedures, and guides
-Work collaboratively with individuals at all levels of the organization while supporting multiple stakeholders

Education and Experience:
-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); or an equivalent combination of education and experience may be qualifying
OTHER INFORMATION

-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. Details about this can be reviewed during the interview process.

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