Payer Strategy & Analytics Senior Finance Manager

About the role

Analytical lead for payer contracting, out-of-network reimbursement and payment dispute work. The person builds the models and tracking that make revenue projections and negotiation plans defensible.

At a glance

What you will do

• Build financial models for payer negotiations, renewals and terminations, comparing in-network and out-of-network outcomes by payer and mark
• Own analytics for No Surprises Act dispute resolution and state arbitration: volume, eligibility, deadlines, cycle time, win rates and award
• Analyze federal dispute resolution public use files and internal determination data to benchmark rates, offers and awards by payer, service,
• Develop offer and rate strategies for dispute submissions and track contract performance, including yield per encounter and underpayments

What they look for

• Experience with payer contracting, reimbursement or revenue cycle analytics in healthcare
• Strong financial modeling skills and comfort working with large datasets
• Ability to work with finance, accounting, legal and revenue cycle leaders and explain recommendations clearly
• Knowledge of the No Surprises Act independent dispute resolution process and state arbitration programs