Hybrid Payor Contract Analyst - Reimbursement & Negotiations

UPMC; Pittsburgh, Northern (Allegheny County, KY); Hybrid; USD 70,000 - 90,000; Full time

Benefits offered by this job

Hybrid work environment

Job summary

UPMC is seeking a Payor Contract Analyst, Intermediate to join our team in a hybrid work environment. The role focuses on developing, negotiating, implementing and maintaining managed care and payor agreements with internal stakeholders.

The successful candidate will analyze contract terms, reimbursement and the financial impact of negotiations, and contribute to revenue optimization across hospital sites. This full-time position offers collaboration across departments and data-driven decision

Qualifications

• Knowledge of payor contracting and managed care agreements.
• Ability to analyze contract terms and reimbursement impact.
• Experience supporting negotiation and financial modeling for contracts.

Responsibilities

• Prepare advanced reimbursement models including payor rates and fee schedules for proposed terms.
• Data mine provider and payor financial data for analysis.
• Test payor claims to ensure accuracy against contract terms.
• Maintain Payor Detail Matrix and Contracted Insurance Matrix for hospitals.
• Research internal payor questions related to contracts and policies.
• Research insurance company policies and rates to support revenue modeling.
• Verify payor rate schedule updates for term compliance.
• Collaborate within the department to maximize outcomes.
• Prepare financial and operational reports to support contractual decisions.

Skills

Payor contracting knowledge

Contract negotiation

Data analysis

Tools

Excel

SQL

Job description

UPMC is seeking a Payor Contract Analyst, Intermediate to join our team in a hybrid work environment. The role focuses on developing, negotiating, implementing and maintaining managed care and payor agreements with internal stakeholders.

The successful candidate will analyze contract terms, reimbursement and the financial impact of negotiations, and contribute to revenue optimization across hospital sites. This full-time position offers collaboration across departments and data-driven decision