Strategic Provider Reimbursement Analyst (Hybrid)

Wellmark, Inc.; Des Moines (IA); Hybrid; USD 90,000 - 120,000; Full time

Job summary

Wellmark, Inc. is seeking a Senior Network Economics Analyst to lead provider reimbursement strategies, analyze data, and advise leadership on payment policy.

This hybrid role requires collaboration with Health Network and Network Economics teams in Des Moines, IA, mentoring peers and driving continuous improvement. The ideal candidate brings 7+ years in health insurance analytics, strong Excel, Power BI, Tableau, SAS EG and SQL skills, and a proven ability to communicate insights to

Qualifications

• Bachelor's degree in accounting, finance, business, economics or related field.
• 7+ years of experience in health insurance, healthcare or related financial industry with financial analysis and data modeling.
• Solid Excel skills and proficiency with Power BI, Tableau, SAS EG and/or SQL.
• Knowledge of provider reimbursement strategies and contracting concepts.
• Understanding of claims data, trends and provider utilization to inform payment strategy.
• Ability to research, analyze and present data-driven insights to leadership.
• Strong communication, collaboration and mentoring capabilities.
• HROR experience highly preferred.

Responsibilities

• Lead, design, implement and maintain provider reimbursement strategies and related financial reporting.
• Perform advanced data analysis to support reimbursement initiatives and pricing recommendations.
• Consult with Network Economics and Health Network stakeholders on payment policy improvements.
• Collaborate with Network Engagement to provide reimbursement guidance to providers.
• Configure, transfer and monitor data in provider payment systems and assist with implementations.
• Manage relationships with provider payment vendors and SLAs.
• Other duties as assigned.

Skills

Excel

Power BI

Tableau

SAS EG

SQL

Education

Bachelor's degree in accounting, finance, business, economics or related field

Tools

Excel

Power BI

Tableau

SAS EG

SQL

Job description

Wellmark, Inc. is seeking a Senior Network Economics Analyst to lead provider reimbursement strategies, analyze data, and advise leadership on payment policy.

This hybrid role requires collaboration with Health Network and Network Economics teams in Des Moines, IA, mentoring peers and driving continuous improvement. The ideal candidate brings 7+ years in health insurance analytics, strong Excel, Power BI, Tableau, SAS EG and SQL skills, and a proven ability to communicate insights to