Senior Healthcare Payer Performance Analyst
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Job Description
Job Family: Business Systems Analysis Travel Required: Up to 10% Clearance Required: None What You Will Do: The Senior Healthcare Payer Performance Analyst supports payer performance, reimbursement, and contract management initiatives through the analysis of complex claims, contracts, fee schedules, and reimbursement data.
This role requires strong analytical judgment, healthcare reimbursement and contract expertise, and the ability to independently investigate issues, identify trends and opportunities, and translate complex data into actionable insights and recommendations.
The ideal candidate is a highly analytical problem solver who can synthesize information from multiple data sources, evaluate financial and operational impacts, perform root-cause analysis, and effectively communicate findings to internal stakeholders, leadership, and clients.
Success in this role requires advanced Excel proficiency, intellectual curiosity, strong business acumen, and the ability to present complex concepts clearly.
In this role you will: Analyze complex physician, facility, and ancillary contract terms, claims data, fee schedules, and reimbursement outcomes to support contract management, modeling, performance monitoring, and issue resolution.
Develop data-driven analyses to identify trends, variances, discrepancies, and financial or operational impacts related to payer contract performance and reimbursement accuracy.
Perform root-cause analysis using contract requirements, claim details, payment data, and operational workflows to distinguish contract configuration, interpretation, reimbursement, and claims-processing issues.
Use Excel and other business intelligence or analytics tools to organize, validate, interpret, summarize, and present complex healthcare data in support of reporting, issue resolution, and decision-making.
Lead analysis workstreams, synthesize findings, prepare clear deliverables, and present conclusions and recommendations to internal stakeholders, operat
Required Skills
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