Note: The job is a remote job and is open to candidates in USA. Privia Health is a technology-driven physician enablement company that collaborates with medical groups and health systems. The Payer Contracting Analyst plays a key role in enabling data-driven decisions on payer contracts, conducting quantitative analyses, and developing insights to support contract strategies and negotiations.
Responsibilities
- Conduct quantitative analyses to evaluate payer performance, utilization trends, cost drivers, and reimbursement outcomes
- Develop insights that support contract strategies, rate negotiations, and value-based care program underwriting
- Responsible for assessing legal and financial implications of all contracting opportunities, including new contacts, contractual amendments and assignments to existing contracts
- Build and maintain fee schedule models to forecast expected reimbursement under various contract terms
- Perform scenario analysis and assess financial impacts of proposed rate changes, proposals, or contract structures
- Assist in the development of value-based care financial models, including shared savings, bundled payments, quality incentive programs, and care coordination fees
- Support ongoing monitoring of value-based program performance and emerging opportunities
- Write SQL queries to extract and analyze medical claims data
- Develop standardized reports and dashboards used for internal reviews and external payer discussions
- Ensure data accuracy, completeness, and consistency across analytical deliverables
- Work closely with the Payer Contracting team to translate analytical findings into compelling insights that inform negotiation strategy
- Collaborate with our Revenue Optimization and Payer Contracting teams to develop reports and alerts that will ensure that Privia is being paid appropriately for fee-for-service and pay-for-performance contracts
- Partner with Finance, Population Health, Revenue Cycle, and Clinical Operations teams as needed
Skills
- Bachelor's degree in a quantitative field (e.g., Economics, Finance, Statistics, Mathematics, Computer Science) or equivalent professional experience
- Experience using SQL
- Strong Microsoft Excel skills, including pivot tables and advanced formulas
- Strong project management and analytical skills, including a desire to logically solve business and technology problems
- Must comply with HIPAA rules and regulations
- Innovative, resourceful, and outcome-driven
- Ability to successfully manage multiple competing priorities
- High attention to detail and quality control
- Strong verbal and written communication skills
- Excellent critical thinking skills and proven track record with presenting quantitative information to non-technical stakeholders
- Healthcare environment experience
- 1+ years experience working with healthcare claims data
Benefits
- Medical, dental, vision, life, and pet insurance
- 401K
- Paid time off
- Other wellness programs
- Annual bonus targeted at 10%
Company Overview
Privia Health is a physician enablement company that provides technology and services to optimize the healthcare delivery experience. It was founded in 2007, and is headquartered in Arlington, Virginia, USA, with a workforce of 501-1000 employees. Its website is http://www.priviahealth.com.
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