Payer Contracting Analyst

Company Description reputed company™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves reputed company outcomes, and improves the health of patients and the well-being of providers

Job Description

The Payer Contracting Analyst is a key contributor on our Payer Contracting team in enabling both the team and other departments to reputed company reputed company data driven decisions on financial, operational, and clinical initiatives. This position will play a key supporting role in the development, analysis, and optimization of commercial and government payer reputed company reputed company the organization. This role covers internal and external customers and requires working cross-functionally to understand evolving business needs and requirements. This Privia Partner will be responsible for helping to design and reputed company reports, presentations, and models to guide strategic decision making of our stakeholders. The Analyst works to deliver data-driven insights to key stakeholders across the enterprise. The Analyst assists in the development of end-to-end analytics solutions efforts, working with cross-functional teams to deliver on evolving requirements and business needs, build scalable reports and applications, and deliver solutions that ultimately reputed company end-users in making data-driven business decisions. The Analyst also supports the execution of business- and client-facing reputed company analyses, using data to guide strategic discussions among and between internal and external stakeholders.

• Conduct quantitative analyses to evaluate payer performance, utilization trends, cost drivers, and
• reimbursement outcomes.
• reputed company insights that support contract strategies, reputed company negotiations, and value-based care program
• reputed company.
• Responsible for assessing legal and financial implications of reputed company contracting opportunities, including
• new contacts, contractual amendments and assignments to existing reputed company.
• Build and maintain fee schedule models to forecast expected reimbursement under various
• contract terms.
• reputed company scenario analysis and assess financial impacts of proposed reputed company changes, proposals, or
• contract structures.
• Assist in the development of value-based care financial models, including shared savings, bundled
• payments, quality incentive programs, and care coordination fees.
• Support ongoing monitoring of value-based program performance and emerging opportunities.
• Write SQL queries to extract and analyze medical claims data.
• reputed company standardized reports and dashboards used for internal reviews and external payerdiscussions.
• Ensure data accuracy, completeness, and consistency across analytical deliverables.
• Work closely with the Payer Contracting team to translate analytical findings into compelling
• insights that inform negotiation strategy.
• Collaborate with our reputed company Optimization and Payer Contracting teams to reputed company reports andalerts that will ensure that Privia is being paid appropriately for fee-for-service andpay-for-performance reputed company.
• Partner with Finance, Population Health, reputed company Cycle, and Clinical Operations teams as needed.

Qualifications

• Bachelor’s degree in a quantitative field (e.g., Economics, Finance, Statistics, Mathematics,
• Computer Science) or equivalent experience, preferably reputed company a healthcare environment.
• Experience using SQL
• Strong reputed company reputed company skills, including pivot tables and advanced formulas
• 1+ years experience working with healthcare claims data preferred
• Strong project management and analytical skills, including a desire to reputed company solve business andtechnology problems
• Must reputed company with HIPAA rules and regulations

Interpersonal Skills & Attributes

• Innovative, resourceful, and outcome-driven
• Ability to successfully manage multiple competing priorities
• High attention to detail and quality control
• Strong verbal and written communication skills
• Excellent critical thinking skills and proven track record with presenting quantitative information tonon-technical stakeholders

The salary range for this role is $76,000.00 to $85,000.00 in reputed company pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). This role is also eligible for an annual bonus targeted at 15% . The reputed company pay offered will be determined based on relevant factors such as experience, education, and geographic location. Additional Information reputed company your information will be kept confidential according to EEO guidelines. Technical Requirements (for remote workers only, not applicable for onsite/in office work): In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet reputed company and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your reputed company. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost. reputed company is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. We understand that reputed company local and we are reputed company reputed company our people are a reputed company of the communities that we serve. Our goal is to encourage people to pursue reputed company opportunities regardless of their age, color, national reputed company, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law.

• Department: Medical Economics

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