Payer Contracting Analyst at Privia Health

, , United States -

Full Time

Start Date

Immediate

Expiry Date

20 Mar, 26

Salary

85000.0

Posted On

20 Dec, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

SQL, Microsoft Excel, Healthcare Claims Data, Project Management, Analytical Skills, Data Analysis, Financial Modeling, Value-Based Care, Communication Skills, Critical Thinking, Attention to Detail, Data Accuracy, Collaboration, Reporting, Dashboards, Negotiation Strategy

Industry

Hospitals and Health Care

Description

Company Description Privia Health™ 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 better 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 make better 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 contracts within 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 develop 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 empower end-users in making data-driven business decisions. The Analyst also supports the execution of business- and client-facing ad hoc 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. 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 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 Revenue Optimization and Payer Contracting teams to develop reports andalerts that will ensure that Privia is being paid appropriately for fee-for-service andpay-for-performance contracts. Partner with Finance, Population Health, Revenue 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 within a healthcare environment. Experience using SQL Strong Microsoft Excel 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 logically solve business andtechnology problems Must comply 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 base 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 base pay offered will be determined based on relevant factors such as experience, education, and geographic location. Additional Information All 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 connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost. Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. We understand that healthcare is local and we are better when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, 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

Responsibilities

The Payer Contracting Analyst will support the development, analysis, and optimization of payer contracts, enabling data-driven decision-making across the organization. This includes conducting quantitative analyses, developing insights for contract strategies, and collaborating with various teams to ensure appropriate reimbursement.