Provider Contracting Analyst II: Reimbursement Modeling & AI

CareSource; Kentucky; On-site; USD 72,000 - 116,000; Full time

Benefits offered by this job

Bonus tied to performance

Job summary

CareSource is seeking a Provider Contracting Analyst II to advance reimbursement strategies through advanced data analysis and AI-enabled tools. You will build models, run repricing analyses, and deliver insights that drive contracting decisions across Medicare, Medicaid, and commercial segments.

The role emphasizes automation, data validation, and collaboration with cross-functional teams to align contract terms with system configuration and analytical outputs.

Qualifications

• Bachelor's degree in Healthcare Administration, Data Analytics, Finance, Economics or related field.
• Two (2) years of experience in healthcare reimbursement, provider contracting or claims data analysis required.
• Experience with data analytics tools, automation, or AI enabled technologies preferred.

Responsibilities

• Develop and maintain provider reimbursement models across multiple payment structures.
• Perform contract repricing analyses using claims data to assess financial impact of proposed rate and contract changes.
• Analyze key financial metrics, including billed charges, allowed amounts, units, and utilization trends.
• Support benchmarking of provider reimbursement rates against Medicare, Medicaid, and commercial benchmarks.
• Utilize SQL, Python, and BI tools to analyze large, complex healthcare datasets.
• Collaborate with contracting, finance, and operational teams to support rate development and network strategy initiatives.

Skills

SQL

Python

Power BI

Tableau

Automation

AI-assisted tools

Analytical reasoning

Education

Bachelor's degree in Healthcare Administration, Data Analytics, Finance, Economics or related field

Job description

CareSource is seeking a Provider Contracting Analyst II to advance reimbursement strategies through advanced data analysis and AI-enabled tools. You will build models, run repricing analyses, and deliver insights that drive contracting decisions across Medicare, Medicaid, and commercial segments.

The role emphasizes automation, data validation, and collaboration with cross-functional teams to align contract terms with system configuration and analytical outputs.