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InterMed, P.A. · 1 month ago

Senior Healthcare Strategy & Contracts Analyst | South Portland, Maine

South Portland, Maine, United States

Full-time

Onsite

Senior Level

5+ years exp

InterMed, P.A. is dedicated to providing patient-centered primary care and seeks a Senior Healthcare Strategy & Contracts Analyst. The role involves leading value-based contracting strategies, serving as a strategic advisor during contract negotiations, and analyzing reimbursement trends to support organizational decision-making.

Health CareMedical

Responsibilities

Lead the development and execution of value-based contracting strategies in partnership with contracting, revenue cycle, value-based care, and clinical leadership, leveraging advanced analytics and data science to drive enterprise-wide results

Serve as a strategic advisor to the contract negotiations team, providing forward-looking analysis of historical and projected performance, and delivering actionable insights on contract proposals and counterproposals

Partner with the Value-Based Care Team to evaluate clinical performance and risk adjustment data across commercial and government payer models, identifying opportunities to optimize outcomes and inform future contracting strategies

Design and enhance supplemental payer data feeds to maximize clinical performance reporting and ensure accurate capture of all risk-adjustable conditions

Analyze reimbursement trends and variances by payer and contract, providing recommendations to senior leadership to inform strategic decision-making

Develop and maintain advanced forecasting methodologies for non–fee-for-service payments, including PMPM, quality incentives, and shared savings, ensuring accurate financial projections

Build, refine, and oversee predictive models to evaluate contract performance, identify improvement opportunities, and support strategic initiatives

Review and validate payer financial settlements, reconciling interim and year-end reports against clinical and operational performance, and advising leadership on resolution of discrepancies

Deliver executive-level insights and reporting on payer performance, profitability, and emerging risks to support strategic decision-making

Lead cross-functional solutions with Contracting, Finance, and Revenue Cycle teams to address complex reimbursement issues and implement sustainable solutions

Assess the impact of new payer policies, regulations, and programs, providing guidance to leadership on potential effects on reimbursement and operational performance

Maintain subject matter expertise on industry trends, reimbursement models, and payer policies, serving as a thought partner to executive and clinical leadership

Maintains strict confidentiality in alignment with HIPAA (Health Insurance Portability and Accountability) guidelines and InterMed policies

Perform other duties to support the mission, vision and values of InterMed

Qualification

Healthcare financeValue-based care strategyAdvanced analyticsPredictive modelingSQLData visualizationHealthcare reimbursementCommunication skillsProject managementOrganizational skills

Required

5–7+ years of progressive healthcare experience, particularly in payer contracting, value-based care strategy, or healthcare finance, with demonstrated strategic responsibility

Bachelor's degree in healthcare administration, business, finance, or a related field required

Proven experience leading cross-functional initiatives across multiple departments and influencing executive-level decision-making to drive organizational strategy

Demonstrated ability to develop forecasting tools, predictive models, and scenario analyses to guide payer contracting strategies and optimize value-based care performance

Exceptional analytical skills with the ability to identify subtle trends in data, develop hypotheses, and translate findings into actionable insights

Advanced analytical expertise with experience in predictive modeling, deductive reasoning, and scenario analysis to support strategic decision-making

Proven ability to lead cross-functional collaboration, working effectively with stakeholders across healthcare, data science, finance, legal, and population health

Proficiency in data analytics tools and techniques, including SQL, Microsoft Excel, and data visualization platforms (e.g., Tableau, Power BI), with experience querying data directly from enterprise data warehouses

Experience with clinical and claims data, including EMR systems, ICD-10, and CPT coding, and the ability to translate this data into actionable contracting insights

Deep knowledge of healthcare reimbursement methodologies, including fee-for-service, capitation, shared savings, and other value-based payment models

Excellent written and verbal communication skills, with the ability to synthesize complex analyses into executive-level recommendations

Strong organizational and project management skills, including the ability to prioritize multiple initiatives, manage deadlines, and drive cross-functional projects to completion