Value-Based Care Financial Analyst

Our Clients; Pasig; On-site; PHP 1,800,000 - 2,700,000; Full time

Job summary

Our Clients is seeking a Value-Based Analyst (Actuarial) to support financial analysis, forecasting, reimbursement modeling, and performance evaluation for US healthcare payer and value-based care arrangements. Direct US healthcare experience and expertise in payer reimbursement are essential.

The role involves building models, analyzing contract performance, and delivering insights to support negotiations, risk assessment, and strategic decisions across Finance and Managed Care teams.

Qualifications

• Bachelor’s degree in Finance, Accounting, Economics, Actuarial Science, Data Analytics, or Healthcare Administration.
• At least 5 years of progressive experience in US healthcare finance, payer analytics, medical economics, healthcare consulting, or a closely related field.
• Direct US healthcare experience is mandatory, including familiarity with US payer systems, reimbursement practices, claims data, or managed care arrangements.
• Demonstrated knowledge of payer reimbursement methodologies, such as DRG, APC, fee schedules, and value-based payment models.
• Experience developing financial models, forecasts, scenario analyses, and contract performance assessments.
• Strong analytical capabilities and experience working with large healthcare claims, reimbursement, or value-based performance datasets.
• Advanced proficiency in SQL, Power BI, Tableau, or comparable analytical and visualization tools.
• Strong communication skills, with the ability to present complex financial findings to technical and non-technical stakeholders.

Responsibilities

• Develop financial models, forecasts, scenario analyses, and expected-versus-actual reimbursement analyses using healthcare claims and financial datasets.
• Analyze payer-specific performance, revenue trends, cost drivers, variances, and financial risks.
• Evaluate reimbursement methodologies, contract rate structures, shared-savings arrangements, and risk-based payment models.
• Apply analytical assumptions and actuarial concepts to support financial projections and contract performance assessments.
• Evaluate value-based contracts, including shared savings, quality incentives, risk corridors, and performance-based payment arrangements.
• Monitor contract performance, reimbursement accuracy, underpayments, and compliance with contractual terms.
• Support payer negotiations through financial impact assessments, sensitivity analyses, and scenario modeling.
• Analyze attribution, quality metrics, reconciliation results, and payment disputes to identify financial and operational opportunities.
• Develop recurring financial reports, dashboards, forecasts, and executive-ready presentations.
• Use healthcare data and market intelligence to identify trends, assess risks, and support strategic recommendations.
• Build and improve analytical tools and methodologies for forecasting, performance monitoring, and financial reporting.
• Collaborate with Finance, Managed Care, and other stakeholders to translate complex analyses into actionable insights.

Skills

Payer Analytics

Value-Based Care

Financial Modeling

SQL

Power BI

Tableau

Contract Analysis

Executive Reporting

Stakeholder Communication

Education

Bachelor’s degree in Finance, Economics, Actuarial Science, Data Analytics, or Healthcare Administration

Master’s degree preferred

Tools

SQL

Power BI

Tableau

Job description

Our Clients is seeking a Value-Based Analyst (Actuarial) to support financial analysis, forecasting, reimbursement modeling, and performance evaluation for US healthcare payer and value-based care arrangements. Direct US healthcare experience and expertise in payer reimbursement are essential.

The role involves building models, analyzing contract performance, and delivering insights to support negotiations, risk assessment, and strategic decisions across Finance and Managed Care teams.