Central California Alliance for Health (Remote) - Payer Analytics Consultant (Temporary)

• 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. • 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 • 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. • This is a temporary position and does not provide the benefits that are listed below (this is standard language from our regular job posts and cannot be altered or removed). Temporary employees on assignment at the Alliance will be connected to a staffing agency with separate benefit options.