Payer Contract Analyst

Summit Orthopedics; Woodbury (MN); On-site; USD 68,000 - 85,000; Full time

Job summary

Summit Orthopedics provides comprehensive orthopedic care across the Twin Cities, Greater Minnesota and Western Wisconsin. The Payer Contract Analyst will interpret reimbursement terms, model financial impact and support negotiations within Revenue Cycle, Operations and Finance.

The role administers Strata analytics, builds models and ensures contractual compliance. Preferred candidates have a Bachelor's degree and at least 3 years in healthcare finance, with strong Excel and PowerBI skills to

Qualifications

• Minimum 3 years of experience in revenue cycle, managed care, healthcare finance or related field.
• Strong analysis skills and proficiency with Excel and PowerBI.
• Payer contracting or understanding of payer reimbursement methodologies preferred.

Responsibilities

• Serves as System Administrator of Strata Decision Technology's Contract Analytics platform
• Builds and maintains reimbursement models for payer contracts
• Translates contract language into expected reimbursement logic
• Analyzes payer proposals or policy changes and models financial impact
• Supports payer rate negotiations, contract renewals and underpayment audit process
• Validates expected reimbursement calculations against actual payments and monitors for compliance or issue escalation
• Assesses Price Transparency data and assists with ensuring Summit is compliant with regulations
• Prepares contract performance reports and payer scorecards
• Performs Ambulatory Surgery Center (ASC) case costing, profitability analysis and special requests, providing recommendations for place of service
• Prepares ad hoc reports and analysis, and performs other duties, as assigned

Skills

Analytical skills

Education

Bachelor's degree (preferred)

Tools

Microsoft Excel

Microsoft PowerBI

Job description

At Summit Orthopedics, we recognize the impact each member of the Summit Family has on one another and on our patients every day. Join a patient-first environment where our values - Better together, Own it, Nimble, Excellence, and Service - are lived down to our BONES. At Summit, team members feel respected, valued, and connected to meaningful work, contributing to a collaborative, community-centered culture built on mutual respect and enjoyment.

Under the direct supervision of the Manager of Financial Planning & Analysis, the Payer Contract Analyst will be responsible for interpreting, modeling, maintaining and monitoring payer contract reimbursement terms. The role will partner with Revenue Cycle, Operations and Finance to ensure payer contracts are accurately represented in contract management system and that payments align with contractual intent.

• Serves as System Administrator of Strata Decision Technology's Contract Analytics platform
• Builds and maintains reimbursement models for payer contracts
• Translates contract language into expected reimbursement logic
• Analyzes payer proposals or policy changes and models financial impact
• Supports payer rate negotiations, contract renewals and underpayment audit process
• Validates expected reimbursement calculations against actual payments and monitors for compliance or issue escalation
• Assesses Price Transparency data and assists with ensuring Summit is compliant with regulations
• Prepares contract performance reports and payer scorecards
• Performs Ambulatory Surgery Center (ASC) case costing, profitability analysis and special requests, providing recommendations for place of service
• Prepares ad hoc reports and analysis, and performs other duties, as assigned

Summit's hiring range for this position is $67.811.43 to $84,764.29 annually. The hired candidate may be eligible to receive additional compensation in the form of bonuses, differentials and/or deferred compensation. In addition to our base salary, we offer a comprehensive total rewards package that aligns with our vision of leading a healthy and active lifestyle. This includes medical, dental, vision, disability, life insurance, paid time off and 401(k)/profit sharing retirement plan. If you are hired at Summit, your final base salary compensation will be determined based on factors such as skills, education, experience, and internal equity.

Summit Orthopedics provides the Twin Cities, Greater Minnesota and Western Wisconsin with the full spectrum of orthopedic care including sub-specialty clinics, walk-in care at our Orthopedic Urgent Care clinics, imaging, bracing, therapy, surgery, and post-surgical stays at our Care Suites. Our expert team of physicians, surgeons, physician assistants, certified athletic trainers and therapists are part of the 1100+ employees who partner to provide quality care designed to support a healthier, more active lifestyle.

Summit Orthopedics is committed to providing equal opportunity to all employees and applicants for employment in accordance with all applicable laws and regulations of federal, state and local governing boards and/or agencies.

Qualifications

Education

Bachelors (preferred)

Experience

Minimum 3 years of experience in revenue cycle, managed care, healthcare finance or related field is required. Must have strong analysis skills and be savvy with tools including Microsoft Excel and Microsoft PowerBI. Payer contracting or understanding of payer reimbursement methodologies preferred. (preferred)

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws.

For further information, please review the Know Your Rights notice from the Department of Labor.