CentraCare · 3 months ago
Financial and Regulatory Analyst
United States
Full-time
Remote
Mid, Senior Level
$64K/yr - $96K/yr
5+ years expCentraCare is seeking a Financial and Regulatory Analyst to support financial analysis, payer policy review, and regulatory compliance. This role involves evaluating the financial impact of payer policies and collaborating with various teams to optimize reimbursement and mitigate regulatory risks.
Health CareMedicalNon Profit
Responsibilities
Monitor and interpret payer policy updates, government reimbursement rules (e.g., Medicare, Medicaid, commercial plans), and legislation impacting financial performance
Analyze changes in payer coverage determinations, billing guidelines, and authorization policies to assess impact on access, documentation, and reimbursement
Collaborate with internal stakeholders to implement payer policy changes and ensure compliance across the revenue cycle and clinical departments
Identify opportunities for revenue enhancement and cost reduction through proactive management of payer policies
Build and maintain financial models to forecast the revenue impact of regulatory or payer policy changes
Analyze variances in net revenue, denials, and reimbursement trends related to policy shifts and provide regular reports to the HealthCare Affordability Committee
Support budget planning and value-based contract modeling by incorporating regulatory and policy data
Develop metrics to track policy compliance, identify gaps, and propose solutions to improve processes and outcomes
Document and communicate findings, recommendations, and action plans to the HealthCare Affordability Committee
Track regulatory requirements from CMS, state Medicaid agencies, and commercial payers
Collaborate with compliance teams and revenue integrity teams to implement and maintain internal controls and audits to minimize risk
Collaborate with payer relations to address any payer-policy-related issues
Monitor adherence to payer policies across the organization
Partner with clinical and operational teams to ensure policy changes are implemented efficiently and effectively
Collaborate with the legal department to review and interpret contracts, agreements, and regulations
Communicate effectively with payers to clarify policy details and resolve disputes
Work closely with the revenue cycle management team to optimize claims processing and reimbursement
Act as a liaison between Finance, Compliance, Managed Care, Revenue Cycle, and Clinical Operations teams
Analyze clinical vendor reimbursement assumptions
Deliver policy summaries and financial impact briefs to operational leaders, with clear recommendations
Support stakeholders on new or updated payer policies and regulatory requirements
Qualification
Required
Bachelor's degree in Finance, Health Administration, Public Health, Economics, or related field or 5+ years of experience in financial analysis, strong report-building skills, payer relations, or regulatory affairs in a healthcare environment
Understanding of Medicare and Medicaid payment systems, managed care contracts, and payer policies required
Proficiency in Excel and financial modeling; ability to interpret large datasets required
Strong analytical, report creation, and critical thinking skills
Clear written and verbal communication
Regulatory and policy acumen
Detail orientation with the ability to synthesize complex information
Collaboration and stakeholder engagement
Preferred
Familiarity with EHR and revenue systems (e.g., Epic, Lawson, Strata, or similar) preferred
Experience with payer audits, prior authorization processes, and coverage policy review preferred
Benefits
Medical
Dental
Flexible spending accounts
PTO
401(k) retirement plan & match
LTD and STD
Tuition reimbursement
Discounts at local and national businesses
Company
CentraCare
CentraCare is a not-for-profit organization that provides health care services.
10001+ employees
H1B Sponsorship
CentraCare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (7)
2024 (2)
2023 (5)
2022 (2)
2021 (2)
2020 (1)
Funding
Current Stage
Late StageLeadership Team
Anthony Gardner
SVP, Chief Marketing & Communications Officer
Santo Cruz
Senior VP & Chief Legal Officer
Recent News
2025-09-12
2025-09-01
2025-08-12
Company data provided by crunchbase