Director, Managed Care and Payer Analytics
A leading healthcare system is seeking a Director, Managed Care & Payer Analytics to serve as the analytics and strategy leader supporting payer contracting, reimbursement performance, and managed care decision-making.
Reporting directly to executive leadership, this individual will serve as the primary analytics expert supporting payer strategy, contract negotiations, and key relationships with commercial and government payers.
This is a rare opportunity for a senior healthcare analytics leader to build a new team from the ground up, partner directly with executive leadership, and shape the analytics function behind payer strategy and contracting decisions. This is not a traditional hospital reporting or population health analytics role. The focus is on managed care contracting, reimbursement analysis, contract modeling, revenue cycle analytics, and translating complex data into actionable business recommendations for executives.
Responsibilities:
- Lead analytics strategy supporting commercial payer contracts, reimbursement analysis, and managed care performance.
- Serve as a strategic advisor to contracting leadership, providing data-driven insights that guide negotiations and payer strategy.
- Analyze contract performance, payment yield, denials, reimbursement methodologies, and settlement activity.
- Develop executive-facing dashboards and reporting that inform financial and operational decision-making.
- Partner closely with payer contracting, finance, revenue cycle, and operational leaders across the organization.
- Leverage Epic Clarity, Caboodle, claims data, and enterprise data warehouses to build scalable analytics solutions.
- Translate complex financial and contract data into actionable recommendations for senior leadership.
- Build, mentor, and lead a new analytics team, with immediate plans to hire multiple analysts.
Experience/Qualifications:
- 8+ years of progressive experience in healthcare analytics, medical economics, healthcare finance, managed care, or payer contracting.
- Strong background supporting payer contracting, reimbursement analysis, managed care operations, or healthcare financial strategy.
- Experience working with Epic Clarity, Caboodle, claims data, and enterprise data warehouses.
- Epic Clarity Certification strongly preferred.
- Advanced SQL and reporting skills, with experience using Power BI, Tableau, Python, or similar analytics tools.
- Proven ability to communicate analytical findings to executive and non-technical audiences.
- Leadership experience building teams, influencing stakeholders, and driving strategic initiatives.
Highlights:
- Fully remote opportunity.
- Newly created position with the opportunity to build and scale an analytics team from day one.
- Direct partnership with executive leadership and significant organizational visibility.
- Strategic role that directly influences payer negotiations and contracting decisions.
- Opportunity to build and shape a brand-new analytics function within a leading academic healthcare organization.
- Unique blend of analytics, payer contracting, healthcare finance, and executive strategy.
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