Value-Based Analyst

Responsibilities:

Perform advanced reimbursement, financial impact, and performance analyses to support managed care contracting and payer strategy.
Support the design of value-based payment models, including shared savings, quality metrics, and risk arrangements.
Provide real-time analytical insights and recommendations during payer negotiations and escalations.
Monitor contract and value-based program performance, identifying underpayments, compliance gaps, unfavorable trends, and financial risk.
Prepare monthly forecasts and financial reports covering value-based performance, reconciliation, and variance analysis.
Conduct quarterly and annual reconciliation audits to ensure payer compliance with contract terms.
Leverage payer data, market trends, and industry insights to inform negotiation strategy and enterprise decisions.
Deliver monthly leadership reporting and ad-hoc analyses to support budgeting, performance monitoring, initiative development, and scenario modeling.

Qualifications:

3+ years of progressive experience in managed care analytics, healthcare finance, payer analytics, medical economics, or related healthcare consulting
Education: Degree background with data analytics/Analysis
Should have strong background in health care economics
Need to have strong audit background - no need to be the lead auditor - more on understanding of audit
Complete forecast - interpretation of IBNR, setting accruals using historical performance
Monthly closing activities, financial packages, interpret new regulations
Flexibility to do Adhoc
Able to handle large set of data and create and translate numbers/analysis to non-finance stakeholders
Creation of dashboards
Tools:Tableau , Microsoft Suite

See also