Senior Healthcare Payer Performance Analyst

Guidehouse Managed Services LLC; Washington (District of Columbia); On-site; USD 89,000 - 148,000; Full time

Benefits offered by this job

Medical

Rx

Dental & Vision Insurance

Paid Holidays

Discretionary bonus

401(k) Retirement Plan

Life Insurance

Health Savings Account

Flexible Spending Accounts

Disability (Short & Long Term)

Tuition Reimbursement

Learning Opportunities

Certifications

Employee Referral Program

Community Outreach

Emergency Back-Up Childcare

Job summary

Guidehouse is seeking a Senior Healthcare Payer Performance Analyst to analyze provider contracts, reimbursement data and performance outcomes. The role emphasizes data-driven insights, root-cause analysis, and clear communication to leadership and clients.

The candidate will leverage advanced Excel and BI tools to deliver actionable recommendations, collaborate across contracting, reimbursement, and analytics teams, and manage multiple priorities in a data-intensive environment.

Qualifications

• Bachelor's degree in healthcare administration, business, finance, or related field.
• 5-7+ years in healthcare data analysis, reimbursement analytics, or related operations.
• Strong understanding of healthcare reimbursement concepts and contract language.
• Experience with payment variance analysis and issue resolution.
• Advanced analytical and critical-thinking skills for large data sets.
• Excellent written, verbal, and presentation skills.

Responsibilities

• Analyze physician, facility, and ancillary contract terms and claims data to support contract management and performance.
• Develop data-driven analyses to identify trends and financial impacts of payer performance.
• Perform root-cause analysis to distinguish contract config, interpretation, and claims issues.
• Use Excel and BI tools to organize and present complex healthcare data for reporting and decision-making.
• Lead analysis workstreams and present conclusions to stakeholders and leadership.
• Collaborate with contracting, reimbursement, operations, and analytics teams to align data outputs with processes.

Skills

Advanced Excel

Data analysis

Root cause analysis

Written and verbal communication

Presentation of findings

Independent work

Stakeholder communication

Problem solving

Education

Bachelor's degree in healthcare administration

Bachelor's degree in business or finance

Tools

Excel

BI tools

Epic

FinThrive

Job description

Job Family: Business Systems Analysis Travel Required: Up to 10% Clearance Required: None

What You Will Do:

The Senior Healthcare Payer Performance Analyst supports payer performance, reimbursement, and contract management initiatives through the analysis of complex claims, contracts, fee schedules, and reimbursement data. This role requires strong analytical judgment, healthcare reimbursement and contract expertise, and the ability to independently investigate issues, identify trends and opportunities, and translate complex data into actionable insights and recommendations. The ideal candidate is a highly analytical problem solver who can synthesize information from multiple data sources, evaluate financial and operational impacts, perform root-cause analysis, and effectively communicate findings to internal stakeholders, leadership, and clients. Success in this role requires advanced Excel proficiency, intellectual curiosity, strong business acumen, and the ability to present complex concepts clearly.

In this role you will:

• Analyze complex physician, facility, and ancillary contract terms, claims data, fee schedules, and reimbursement outcomes to support contract management, modeling, performance monitoring, and issue resolution.
• Develop data-driven analyses to identify trends, variances, discrepancies, and financial or operational impacts related to payer contract performance and reimbursement accuracy.
• Perform root‑cause analysis using contract requirements, claim details, payment data, and operational workflows to distinguish contract configuration, interpretation, reimbursement, and claims-processing issues.
• Use Excel and other business intelligence or analytics tools to organize, validate, interpret, summarize, and present complex healthcare data in support of reporting, issue resolution, and decision-making.
• Lead analysis workstreams, synthesize findings, prepare clear deliverables, and present conclusions and recommendations to internal stakeholders, operational leaders, and other audiences as needed.
• Partner with contracting, reimbursement, operations, analytics, and leadership teams to clarify requirements, resolve issues, and align contract terms, data outputs, and operational processes.
• Manage multiple priorities while maintaining a high degree of accuracy, attention to detail, sound judgment, and timely delivery in a data-intensive environment.

What You Will Need:

• 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, fee schedules, contract interpretation, and how contract terms translate into data and payment outcomes.
• Experience performing payment variance analysis, root-cause analysis, and issue resolution in a healthcare setting.
• Advanced analytical and critical‑thinking skills, with the ability to evaluate large or complex data sets, identify actionable insights, and translate findings into practical recommendations.
• Strong knowledge of medical terminology and healthcare coding concepts, including CPT, HCPCS, ICD, and revenue codes.
• Advanced Microsoft Excel and Office proficiency, including experience organizing, analyzing, validating, summarizing, and presenting data; experience with business intelligence, reporting, or analytics tools is preferred.
• Excellent written, verbal, communication, and presentation skills, including the ability to lead discussions, present analytical findings, and explain complex contract, reimbursement, and data concepts clearly to non-technical stakeholders and leadership.
• Demonstrated ability to work independently, exercise sound judgment, manage high-complexity analytical assignments, and communicate risks, findings, and recommendations effectively.

What Would Be Nice To Have:

• Experience with FinThrive.
• Experience with Epic.

The annual salary range for this position is $89,000.00-$148,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

• Medical
• Rx
• Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account
• Dental/Vision & Dependent Care
• Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement
• Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back‑Up Childcare Program

About Guidehouse

Guidehouse is an Equal Opportunity Employer - Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation. Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco. If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at [e-mail]. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation. All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or [e-mail]. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse.

Guidehouse is a global AI‑led professional services firm delivering advisory, technology, and managed services to the commercial and government sectors. With an integrated business technology approach, Guidehouse drives efficiency and resilience in the healthcare, financial services, energy, infrastructure, and national security markets. Built to help clients across industries outwit complexity, the firm brings together approximately 18,000 professionals to achieve lasting impact and shape a meaningful future. guidehouse.com