Strategic Provider Payment Analyst II

Partnership HealthPlan of California; Fairfield (CA); On-site; USD 80,000 - 110,000; Full time

Job summary

Partnership HealthPlan of California is seeking a reimbursement strategy expert to support the development and evaluation of reimbursement methodologies in a fast-paced environment. The successful candidate will provide analyses to inform executive leadership, create reimbursement strategies, and act as a subject matter expert on provider network and payment methodologies. Candidates should have at least 4 years of experience in managed care and a relevant degree.

Qualifications

• Minimum 4 years of experience in a managed care organization or health insurer.
• Experience with physician/facility/ancillary reimbursement methodologies preferred.
• Knowledge of State and Federal regulatory bodies such as CMS and DHCS.

Responsibilities

• Support the development of provider reimbursement methodologies.
• Conduct complex research and analyze data sources.
• Advise leadership on reimbursement strategies and compliance.

Skills

Project Management

Financial Analysis

Negotiation

Data Analysis

Communication

Education

Bachelor's degree in Business Administration, Computer Science, Healthcare Administration, or related field

Tools

Microsoft Excel

Business Intelligence Software

Job description

Partnership HealthPlan of California is seeking a reimbursement strategy expert to support the development and evaluation of reimbursement methodologies in a fast-paced environment. The successful candidate will provide analyses to inform executive leadership, create reimbursement strategies, and act as a subject matter expert on provider network and payment methodologies. Candidates should have at least 4 years of experience in managed care and a relevant degree.