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Scripps Health

Senior Payer Contracting Data Analyst

Posted 2 days ago
2-5 years experience
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AI Summary

The analyst will transform complex payer data into actionable insights to drive smarter contract decisions and optimize reimbursement terms. They will lead cross-functional efforts to negotiate, monitor, and audit payer relationships to support financial strategy and revenue growth.

This is a full time, benefited, salaried role. This position is work-from-home.  

Join the Scripps Health team and work alongside passionate caregivers and provide patient-centered healthcare. Receive endless appreciation while you build a rewarding career with one of the most respected healthcare organizations nationwide. 

Why join Scripps Health? 

At Scripps Health, your ambition is empowered and your abilities are appreciated:

  • Nearly a quarter of our employees have been with Scripps Health for over 10 years.
  • Scripps is a Great Place to Work Certified company for 2025.
  • Scripps Health has been consistently ranked as a top employer for women, millennials, diversity, and as an overall workplace by various national publications.
  • Beckers Healthcare ranked Scripps Health on its 2024 list of 150 top places to work in health care.
  • We have transitional and professional development programs to create a learning environment that enables you to thrive in your specific field as well as in your overall career.
  • Our specialties have been nationally recognized for quality in areas such as cardiovascular care, oncology, orthopedics, geriatrics, obstetrics and gynecology, and gastroenterology.

Why join this team?

The Payer Relations team plays a critical role in advancing Scripps Health’s financial strategy and long-term growth. We are looking for a Data Analyst to support our vision to transform payer relationships from transactional to strategic by leveraging data and analytics to predict, model and secure optimal reimbursement terms while achieving sustainable net revenue growth and margin targets.

Responsibilities include:

·       Responsible for transforming complex payer data into actionable insights that drive smarter contract decisions.

·       Analyze complex data sets, proactively explore insights, and clearly communicate findings to both clinical and operational stakeholders.

·       Lead cross functional efforts across finance, strategy, and health system performance, to effectively negotiate, monitor, and optimize payer relationships.

·       Provide the analytical foundation for strategic growth, lead reimbursement modeling, trend analysis, financial proposal development, contract term optimization, risk assessment, and payer performance audits.

·       Direct business analysis for new and renewing payer contract negotiations, maintain payer contract portfolio reporting, and serve as a key partner to revenue cycle and other internal teams.



Required Education/Experience/Specialized Skills: 

·       Bachelor's degree in business, math or health administration.

·       3 years broad-base healthcare experience with knowledge of healthcare products and services knowledge.

·       Expert knowledge of Microsoft Excel, SQL and data manipulation.

·       Excellent communication skills and exceptional relationship-building skills.

·       Strong SQL and data manipulation skills, Detail-oriented with strong analytical abilities.

·       Ability to work both independently and as part of a team.

·       Strategic and critical thinking skills.

·       Strong problem-solving skills and the ability to adapt


 

Preferred Education/Experience/Specialized Skills/Certification: 

·       Master's degree in business, health administration, math or statistics preferred.

·       Knowledge and understanding of EPIC, Business Intelligence reporting technologies, and data mart technologies and principles.

·       Strong understanding of healthcare payer systems, reimbursement models, and insurance policies.

·       Knowledge of CPT, HCPCS, ICD-10, facility revenue codes and healthcare claims data; experience with billing/payment systems.

·       Experience maintaining expected reimbursement in contract management systems (e.g., EPIC).

·       Ability to analyze data and make data-driven decisions.

·       Knowledge of healthcare regulations and compliance standards.

·       Proficiency in Strata Axiom contract management software and Epic EHR, including Cogito - Slicer Dicer

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