Senior Value-Based Contracting & Reimbursement Analyst

CenCal Health; United States; On-site; USD 110,000 - 160,000; Full time

Job summary

CenCal Health is seeking a Sr. Healthcare Provider Contracting Analyst to independently perform complex financial modeling, rate development, and provider contract change analysis for Medicaid Managed Care and Medicare Advantage D-SNP plans.

You will use advanced SQL and claims data analysis to assess financial impact across FFS, capitation, and value-based arrangements, while ensuring regulatory compliance and affordability objectives.

Qualifications

• Bachelor's degree in Finance, Accounting, Economics, Healthcare Administration, or related field.
• Five+ years of healthcare financial analysis experience.
• Three+ years of healthcare reimbursement analysis or contract financial analysis.
• Experience supporting a Medicaid Managed Care Plan or Medicaid line of business.
• Advanced SQL experience with complex joins, subqueries, and aggregations.

Responsibilities

• Perform complex financial modeling, reimbursement rate development, and provider contract change analysis for Medicaid Managed Care & Medicare Advantage D-SNP plans.
• Analyze utilization and unit cost data to assess financial impact of provider contracts across FFS, capitation, and value-based arrangements.
• Develop scenario-based financial models to support contracting negotiations and leadership decisions.
• Collaborate with Provider Contracting, Provider Relations, Quality, and IT/Data Analytics teams.
• Ensure data governance, regulatory compliance, and documentation of methodologies.

Skills

Advanced SQL

Data analysis

Financial modeling

Provider reimbursement

Value-based payment analytics

Cross-functional collaboration

Regulatory compliance

Data governance

Analytical thinking

Communication skills

Education

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

Tools

SQL

Microsoft Excel

Job description

CenCal Health is seeking a Sr. Healthcare Provider Contracting Analyst to independently perform complex financial modeling, rate development, and provider contract change analysis for Medicaid Managed Care and Medicare Advantage D-SNP plans.

You will use advanced SQL and claims data analysis to assess financial impact across FFS, capitation, and value-based arrangements, while ensuring regulatory compliance and affordability objectives.