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Privia Health · 10 hours ago

Payer Contracting Analyst

United States

Full-time

Remote

Entry Level

$76K/yr - $85K/yr

1+ years exp

Privia Health is a technology-driven, national physician enablement company that aims to optimize physician practices and improve patient experiences. The Payer Contracting Analyst will contribute to the Payer Contracting team by analyzing and optimizing payer contracts, delivering data-driven insights, and collaborating with various departments to support strategic decision-making.

Health CareHospitalInformation TechnologyManagement Information SystemsMedicalOutpatient CareWellness

Growth Opportunities

Responsibilities

Conduct quantitative analyses to evaluate payer performance, utilization trends, cost drivers, and reimbursement outcomes

Develop insights that support contract strategies, rate negotiations, and value-based care program underwriting

Responsible for assessing legal and financial implications of all contracting opportunities, including new contacts, contractual amendments and assignments to existing contracts

Build and maintain fee schedule models to forecast expected reimbursement under various contract terms

Perform scenario analysis and assess financial impacts of proposed rate 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

Develop standardized reports and dashboards used for internal reviews and external payer discussions

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 Revenue Optimization and Payer Contracting teams to develop reports and alerts that will ensure that Privia is being paid appropriately for fee-for-service and pay-for-performance contracts

Partner with Finance, Population Health, Revenue Cycle, and Clinical Operations teams as needed

Qualification

SQLMicrosoft ExcelHealthcare claims dataQuantitative analysisProject managementResourcefulCommunication skillsCritical thinkingAttention to detailInnovative

Required

Bachelor's degree in a quantitative field (e.g., Economics, Finance, Statistics, Mathematics, Computer Science) or equivalent experience, preferably within a healthcare environment

Experience using SQL

Strong Microsoft Excel skills, including pivot tables and advanced formulas

Strong project management and analytical skills, including a desire to logically solve business and technology problems

Must comply with HIPAA rules and regulations

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 to non-technical stakeholders