Healthcare Payer Performance Analytics Lead

US104 Guidehouse Managed Services LLC; Lewisville (TX); On-site; USD 89,000 - 148,000; Full time

Benefits offered by this job

Medical, Rx, Dental & Vision Insurance

401(k) Retirement Plan

Company Paid Holidays

Job summary

Guidehouse is seeking a Senior Healthcare Payer Performance Analyst in Texas to support payer performance, reimbursement, and contract management initiatives. The role involves analyzing complex claims, contracts, and reimbursement data to produce actionable insights and recommendations.

The ideal candidate has 5–7+ years in healthcare data analysis, reimbursement analytics, and contract management, with advanced Excel and BI skills and strong communication abilities.

Qualifications

• Bachelor’s degree in healthcare administration, business, finance, or a related field.
• 5–7+ years of experience in healthcare data analysis, reimbursement analytics, contract management, managed care, revenue cycle, payer/provider contracting, or a related healthcare operations environment.
• Strong understanding of healthcare reimbursement concepts, provider and payer contract language, and fee schedules.

Responsibilities

• Analyze complex physician, facility, and ancillary contract terms, claims data, fee schedules, and reimbursement outcomes to support contract management and performance monitoring.
• Develop data-driven analyses to identify trends, variances, discrepancies, and financial or operational impacts related to payer contract performance.
• Perform root-cause analysis using contract requirements, claim details, payment data, and workflows to distinguish contract issues.
• Use Excel and BI tools to organize, validate, interpret, summarize, and present complex healthcare data for reporting and decision-making.
• Lead analysis workstreams, synthesize findings, prepare deliverables, and present conclusions to stakeholders.
• Partner with contracting, reimbursement, operations, analytics, and leadership teams to clarify requirements and align outputs.

Skills

Analytical thinking

Problem solving

Communication

Presentation

Independent work

Education

Bachelor’s degree in healthcare administration, business, finance, or related field

Tools

Excel

Business Intelligence Tools

Analytics tools

Job description

Guidehouse is seeking a Senior Healthcare Payer Performance Analyst in Texas to support payer performance, reimbursement, and contract management initiatives. The role involves analyzing complex claims, contracts, and reimbursement data to produce actionable insights and recommendations.

The ideal candidate has 5–7+ years in healthcare data analysis, reimbursement analytics, and contract management, with advanced Excel and BI skills and strong communication abilities.