Job Details

Senior Payer Strategy Analyst
Remote Role
This is a Remote role.
Compensation: $60-70/hr

ABOUT THE ROLE

Our Client is seeking a Senior Payer Strategy Analyst to play a pivotal, high-impact role in modeling reimbursement rates, analyzing payer performance, and providing financial insights that directly influence contract negotiations and revenue optimization across the health system. This strategic position requires advanced analytical abilities, deep expertise in healthcare reimbursement methodologies—including Medicare distinctions—and proficiency with financial and clinical systems such as Epic and Excel. The analyst will serve as a key advisor to leadership, preparing detailed models and reports, participating in negotiation meetings, and delivering data-driven recommendations that shape payer strategy and financial planning. The ideal candidate is a self-starter with strong critical thinking skills, capable of managing multiple projects independently and contributing to the organization’s payer strategy and financial planning.

WHAT YOU’LL DO

• Model reimbursement rates and analyze payer performance to inform contract negotiations and revenue optimization.
• Prepare detailed financial models and reports to support payer negotiations and strategic conversations.
• Deliver data-driven insights and recommendations to leadership for payer strategy and financial planning.
• Extract, analyze, and report data using advanced Excel, SQL, and Epic systems.
• Manage multiple report requests via Smartsheet work queue, ensuring timely and accurate delivery (typical turnaround: 1-3 weeks per project).
• Attend and contribute to weekly negotiation meetings with payers and contract negotiators.
• Independently handle projects, prioritize workload, and meet turnaround expectations with strong time management.
• Collaborate with team members and adapt to shifting assignments based on workload; analysts are assigned to specific payers but may interchange as needed.
• Apply deep knowledge of hospital and physician reimbursement methodologies, including Medicare distinctions.
• Conduct root cause analysis and apply critical thinking to resolve complex issues.
• Develop Power BI dashboards (preferred) and leverage SQL reporting in Epic (strong plus).
• Read and interpret Explanation of Benefits (EOBs) to inform analysis and reporting.

WHAT YOU BRING

• Advanced Excel proficiency, including pivot tables, VLOOKUP, graphs, and complex modeling.
• SQL programming skills and experience extracting data from Epic.
• Epic certification (models in Epic + Excel preferred); double certification in hospital and physician reimbursement contracts required within 90 days of hire.
• Experience with Epic required.
• Ability to read and understand EOBs (Explanation of Benefits).
• Strong time management and independent project handling skills.
• Critical thinking skills and experience with root cause analysis.
• Deep understanding of hospital and physician reimbursement, including Medicare distinctions.
• Power BI dashboard development preferred but not required.
• Self-starter mentality and ability to work independently.
• SQL reporting in Epic is a strong plus.