Senior Healthcare Payer Performance Analyst

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🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $89k - $148k / year

⏰ Full Time

🟠 Senior

🧐 Analyst

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Guidehouse

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 2018

🏥 Healthcare

🎖️ Defense

📦 Logistics

💰 Grant on 2023-02

Healthcare • Defense • Logistics

Guidehouse is a global consultancy offering advisory, digital, and managed services across commercial and public sectors. It is purpose-built to support industries such as national security, financial services, healthcare, energy, and infrastructure. Guidehouse collaborates with leaders to navigate complexity and drives transformational changes that impact the future. Their expertise spans data analytics, digital technologies, risk management, and more, with a strong emphasis on sustainability and innovation.

📋 Description

• Analyze complex physician, facility, and ancillary contract terms, claims data, fee schedules, and reimbursement outcomes • Develop data-driven analyses to identify trends, variances, discrepancies, and financial or operational impacts • Perform root-cause analysis of contract configuration, interpretation, reimbursement, and claims-processing issues • Use Excel and business intelligence or analytics tools to organize, validate, interpret, summarize, and present healthcare data • Lead analysis workstreams, synthesize findings, prepare deliverables, and present conclusions and recommendations • Partner with contracting, reimbursement, operations, analytics, and leadership teams to clarify requirements and resolve issues • Manage multiple priorities while maintaining accuracy, attention to detail, sound judgment, and timely delivery

🎯 Requirements

• Bachelor’s degree in healthcare administration, business, finance, or a related field • 5–7+ years of experience in healthcare data analysis, reimbursement analytics, contract management, managed care, revenue cycle, payer/provider contracting, or related healthcare operations • Strong understanding of healthcare reimbursement concepts, provider and payer contract language, fee schedules, contract interpretation, and payment outcomes • Experience performing payment variance analysis, root-cause analysis, and issue resolution in a healthcare setting • Advanced analytical and critical-thinking skills for evaluating large or complex data sets and translating findings into recommendations • Strong knowledge of medical terminology and healthcare coding concepts, including CPT, HCPCS, ICD, and revenue codes • Advanced Microsoft Excel and Office proficiency • Experience with business intelligence, reporting, or analytics tools preferred • Excellent written, verbal, communication, and presentation skills • Ability to work independently, exercise sound judgment, manage high-complexity analytical assignments, and communicate risks, findings, and recommendations • Experience with FinThrive would be nice to have • Experience with Epic would be nice to have

🏖️ Benefits

• Medical, Rx, Dental & Vision Insurance • Personal and Family Sick Time • Company Paid Holidays • Position may be eligible for a discretionary variable incentive bonus • Parental Leave • 401(k) Retirement Plan • Basic Life & Supplemental Life • Health Savings Account • Dental/Vision & Dependent Care Flexible Spending Accounts • Short-Term & Long-Term Disability • Tuition Reimbursement • Personal Development & Learning Opportunities • Skills Development & Certifications • Employee Referral Program • Corporate Sponsored Events & Community Outreach • Emergency Back-Up Childcare Program