Payer Analytics Consultant – Defined Term

Central California Alliance for Health

. Design and validate managed care payer models .

Posted 10/10/2026full-timeCalifornia • United StatesMid-LevelSenior💰 $118,000 - $140,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in financial healthcare reimbursement analysis, including knowledge of provider reimbursement methodologies and financial modeling techniques. Proficient in data analysis and visualization tools to support payer reimbursement objectives and enhance decision-making processes.

Highest-signal resume keywords

Financial Healthcare Reimbursement AnalysisProvider Reimbursement MethodologiesData Modeling TechniquesSQLTableau

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Financial AnalysisFinancial ModelingData AnalysisData InterpretationCritical ThinkingResearch SkillsTroubleshootingProcess Improvement

Soft Skills

CollaborationCommunicationAnalytical Skills

Tools & Technologies

Microsoft ExcelMicrosoft WordMicrosoft PowerPointMicrosoft AccessVisual BasicWindows-based PC Systems

Industry Keywords

Healthcare Industry TermsFee-for-ServiceValue-Based ReimbursementRisk-Sharing ModelsPayer Reimbursement Methodologies

Tech Stack

Tools & technologies

SQLTableau

About the role

Key responsibilities & impact

Design and validate managed care payer models
Perform moderately complex analysis to evaluate the feasibility of payer reimbursement methodologies
Conduct moderately complex financial analysis to support successful payer reimbursement outcomes
Coordinate and collaborate with internal and external stakeholders to achieve payer reimbursement objectives
Report to the Payment Strategy Director
Support the Payment Strategy department’s work to ensure network payments are adequate to revenue, advance payment methodology, achieve quality healthcare, and reduce costs

Requirements

What you’ll need

Bachelor’s degree in Business Administration, Accounting, Finance, Healthcare, or a related field
Minimum of three years of experience performing financial healthcare reimbursement analysis
A Master’s degree may substitute for two years of the required experience
Equivalent combination of education and experience may be qualifying
Knowledge of Windows-based PC systems and Microsoft Word, Outlook, PowerPoint, Access, Visual Basic, Excel including pivot tables, and database systems
Knowledge of financial modeling and analysis methods and techniques
Knowledge of provider reimbursement methodologies, pricing, and fee schedules for hospital, physician, and ancillary providers
Knowledge of healthcare industry terms and healthcare-related data types and structures
Knowledge of fee-for-service and value-based provider reimbursement methodologies, including risk-sharing models
Knowledge of data modeling techniques, SQL, business analytical and data mining tools, and Tableau
Ability to collect, interpret, and evaluate data; detect patterns; develop solutions; and project consequences of recommendations
Strong analytical, critical thinking, and research skills
Ability to troubleshoot issues, identify alternative solutions, and make recommendations
Ability to translate data into understandable information and deliver process-improving solutions
Ability to act as a technical resource and explain related regulations, processes, and programs
Ability to interpret and apply rules, regulations, policies, procedures, and guides
Ability to work collaboratively with individuals at all organizational levels while supporting multiple stakeholders
Must be currently authorized to work in the United States on a full-time, ongoing basis without current or future employer sponsorship

Benefits

Comp & perks

Fully benefited position
Medical, Dental and Vision Plans
Ample Paid Time Off
12 Paid Holidays per year
401(a) Retirement Plan
457 Deferred Compensation Plan
Robust Health and Wellness Program
Onsite EV Charging Stations
Attendance at quarterly company-wide events or department meetings