Payer Analytics Consultant (Defined Term)

SERVICE AREA PREFERENCE

While we encourage all interested applicants to apply, we do give priority to those who live in, or near, our service counties: Santa Cruz, Monterey, Merced, San Benito, and Mariposa. Our mission of accessible, quality health care guided by local innovation leads everything we do, and having team members who are connected to the communities we serve strengthens our ability to deliver on that commitment.

WHAT YOU'LL BE RESPONSIBLE FOR

• Designs and validates managed care payer models and performs moderately complex analysis to evaluate the feasibility of payer reimbursement methodologies
• Conducts moderately complex financial analysis to support successful payer reimbursement outcomes
• Coordinates and collaborates with internal and external stakeholders to achieve payer reimbursement objectives

ABOUT THE TEAM

The Payment Strategy department ensures the Alliance's payments to our network are adequate to our revenue. We also work to advance our payment methodology in order to achieve the best quality healthcare while reducing costs.

THE IDEAL CANDIDATE

• Technically strong, with proven experience in payer financial modeling, provider payment methodologies, payment structure design, and reimbursement strategy development.
• Analytical and detail-oriented, skilled in data interpretation, trend analysis, and scenario modeling to inform decision-making and optimize payment accuracy.
• Collaborative and solutions-focused, working effectively across departments — including finance, provider network management, operations, and clinical teams — to align analytics with business goals.