Senior Payer Analytics Specialist
4 weeks ago
Job Description Overview
SCA Health is seeking a Senior Payer Analytics Analyst to join the Catalyst Analytics team. This role will involve examining and organizing complex data for multiple ASC contract and development negotiations, as well as exploring nuances of the data to drive decisions through report preparation and analysis.
Responsibilities
- Partner with contract negotiators to identify key variables and preliminary strategies for upcoming projects, then generate accurate and instructive analytical models that reflect these inputs.
- Collaborate with regional business development leaders to evaluate potential acquisitions, using a combination of external and internal claims data.
- Support cross-functional team members with development, implementation, and maintenance of operational reports and analytical dashboards.
- Help design and implement improvements to established or proposed reimbursement process.
- Develop effective quality control processes to ensure data integrity.
- Review claims data to ensure accurate and adequate payment.
- Present ideas and participate in meetings, actively seeking new opportunities to contribute.
- Retrieve, organize, and manipulate data from the Enterprise Data Warehouse and other databases to prepare data for reporting and analysis.
- Uphold and practice the principles and policies of the SCA Compliance program.
Qualifications
- Bachelor's degree in Actuarial Science, Mathematics, Statistics, Economics, or related field.
- 3+ years of analytical experience in a Healthcare/Managed Care environment required.
- Travel to company meetings (10%).
- MS SQL Server (Strong command over T-SQL) required.
- Advanced experience in Excel.
- Experience in hospital, health plan, risk-based care delivery organizations, or physician claims analytics.
- Experience working with large healthcare claims data.
- Clinical code knowledge (ICD, CPT, Rev Codes, etc.) related to medical claims/utilization data strongly preferred.
- Tableau BI tool experience preferred.
- Acute attention to detail and strong analytical and critical thinking skills.
- Experience with managed care contract terms analysis.
- Strong written and verbal communication skills, including the ability to communicate results of data analysis to a variety of stakeholders.
Salary Range
USD $67,950.00/Yr. - USD $85,000.00/Yr.
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