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Headquartered in San Diego, California, Scripps Health has provided quality healthcare to the community of La Jolla, California, for more than 80 years. A priva
Payer Contracting Data Analyst
Location
United States
Posted
10 days ago
Salary
0
Seniority
Mid Level
Job Description
Payer Contracting Data Analyst
Scripps Health
Role Description This is a full time, benefited, salaried role. This position is work-from-home. Join the Scripps Health team and work alongside passionate caregivers and provide patient-centered healthcare. Receive endless appreciation while you build a rewarding career with one of the most respected healthcare organizations nationwide. Why join this team? - The Payer Relations team plays a critical role in advancing Scripps Health’s financial strategy and long-term growth. - We are looking for a Data Analyst to support our vision to transform payer relationships from transactional to strategic. - Leverage data and analytics to predict, model and secure optimal reimbursement terms while achieving sustainable net revenue growth and margin targets. Responsibilities include: - Responsible for transforming complex payer data into actionable insights that drive smarter contract decisions. - Analyze complex data sets, proactively explore insights, and clearly communicate findings to both clinical and operational stakeholders. - Lead cross functional efforts across finance, strategy, and health system performance, to effectively negotiate, monitor, and optimize payer relationships. - Provide the analytical foundation for strategic growth, lead reimbursement modeling, trend analysis, financial proposal development, contract term optimization, risk assessment, and payer performance audits. - Direct business analysis for new and renewing payer contract negotiations, maintain payer contract portfolio reporting, and serve as a key partner to revenue cycle and other internal teams. Qualifications - Bachelor's degree in business, math or health administration. - 3 years broad-base healthcare experience with knowledge of healthcare products and services knowledge. - Expert knowledge of Microsoft Excel, SQL and data manipulation. - Excellent communication skills and exceptional relationship-building skills. - Strong SQL and data manipulation skills, detail-oriented with strong analytical abilities. - Ability to work both independently and as part of a team. - Strategic and critical thinking skills. - Strong problem-solving skills and the ability to adapt. Requirements - Master's degree in business, health administration, math or statistics preferred. - Knowledge and understanding of EPIC, Business Intelligence reporting technologies, and data mart technologies and principles. - Strong understanding of healthcare payer systems, reimbursement models, and insurance policies. - Knowledge of CPT, HCPCS, ICD-10, facility revenue codes and healthcare claims data; experience with billing/payment systems. - Experience maintaining expected reimbursement in contract management systems (e.g., EPIC). - Ability to analyze data and make data-driven decisions. - Knowledge of healthcare regulations and compliance standards. - Proficiency in Strata Axiom contract management software and Epic EHR, including Cogito - Slicer Dicer.
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