Location: Remote (California Preferred)

Schedule: Full-Time | Exempt

About Our Client:

Our client is a mission-driven healthcare organization dedicated to improving access to high-quality, affordable care for the communities they serve. As a leader in managed care, they partner with providers and community organizations to deliver innovative healthcare solutions while maintaining a strong commitment to collaboration, accountability, and continuous improvement.

They are seeking an experienced healthcare finance professional to join their Financial Analysis team and play a key role in supporting provider reimbursement strategies, contract negotiations, and value-based payment initiatives.

Position Overview:

The Sr. Healthcare Provider Contracting Analyst will serve as a strategic financial partner to Provider Contracting and leadership by performing complex financial modeling, reimbursement analysis, and provider contract evaluations across Medicaid Managed Care and Medicare Advantage lines of business.

This role will leverage advanced SQL, claims data analytics, and financial modeling to evaluate provider reimbursement methodologies, assess contract performance, and provide data-driven insights that support contracting decisions and organizational objectives.

Key Responsibilities:

Provider Contract Financial Analysis:

• Analyze the financial impact of new provider contracts, renewals, amendments, and reimbursement changes
• Evaluate fee-for-service, capitation, value-based payment models, and alternative reimbursement arrangements
• Perform utilization, unit cost, PMPM, and total cost of care analyses using healthcare claims data
• Develop financial recommendations to support provider contracting strategies

Financial Modeling & Reimbursement:

• Build financial models supporting provider reimbursement methodologies, including fee-for-service, bundled payments, capitation, and value-based care arrangements
• Develop scenario analyses to evaluate financial risk and contract performance
• Support reimbursement methodologies aligned with Medicaid and Medicare regulations

Data Analytics & Reporting:

• Utilize advanced SQL to extract, analyze, and validate large healthcare claims datasets
• Create meaningful financial reports and analytical tools to support leadership decision-making
• Identify financial trends, reimbursement opportunities, and areas of risk
• Partner with Data Analytics to ensure data accuracy and reporting integrity

Cross-Functional Collaboration:

• Partner closely with Provider Contracting, Provider Relations, Finance, Quality, and Clinical teams
• Translate complex financial analyses into clear, actionable business recommendations
• Support contract negotiations with data-driven financial insights
• Contribute to process improvement initiatives and analytical best practices

Qualifications:

• Bachelor's degree in Finance, Accounting, Economics, Healthcare Administration, or a related field
• Five or more years of healthcare financial analysis experience within managed care, healthcare finance, provider contracting, or health plan operations
• Experience supporting Medicaid Managed Care and/or Medicare Advantage programs
• Strong understanding of provider reimbursement methodologies, including fee-for-service, capitation, and value-based payment models
• Advanced SQL experience with the ability to analyze large healthcare claims datasets
• Advanced Microsoft Excel skills, including financial modeling and scenario analysis
• Experience interpreting healthcare claims data and presenting financial findings to business leaders
• Strong analytical, communication, and problem-solving skills with the ability to manage multiple priorities in a collaborative environment

Compensation & Benefits:

• Base salary range of $120,970–$181,455, depending on experience
• Comprehensive benefits package
• Fully remote opportunity with a collaborative and mission-driven organization
• Opportunity to make a meaningful impact by supporting healthcare affordability and provider partnership strategies