Senior Healthcare Provider Contracting Analyst

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🔥 2 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $121k - $181.5k / year

⏰ Full Time

🟠 Senior

🧐 Analyst

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CenCal Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1983

⚕️ Healthcare Insurance

Healthcare Insurance

CenCal Health is a local health plan that provides Medi‑Cal and related managed-care services to residents, offering member-centered coverage, care coordination, and community health programs. It administers Medi‑Cal benefits, a dual-eligible product (CenCal CareConnect), pharmacy and provider network services, nurse advice and after-hours care, case management and CalAIM-enhanced care management, and resources for members and providers. CenCal Health also engages in community outreach, reporting, and provider support to improve population health in its service area.

📋 Description

• Perform detailed financial impact analysis for new provider contracts, renewals, amendments, and rate adjustments. • Develop provider reimbursement models and financial methodologies to support value based contract components. • Use advanced SQL to extract, transform, and analyze large Medicaid claims datasets. • Partner closely with Provider Contracting to support negotiations with data backed financial insights. • Document assumptions, methodologies, benchmarks, and reconciliation logic supporting provider contract financial reviews.

🎯 Requirements

• Bachelor’s degree in Finance, Accounting, Economics, Healthcare Administration, or related field. • Minimum of five (5) years of progressively responsible healthcare financial analysis experience, preferably within healthcare, managed care, provider contracting, or health plan operations. • Minimum of three (3) years of experience performing healthcare reimbursement analysis, provider payment modeling, or contract financial analysis. • Experience supporting a Medicaid Managed Care Plan or Medicaid line of business. • Advanced experience using SQL, including: complex joins, subqueries, aggregations, and performance conscious query design.