Job Description
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The job is a remote job and is open to candidates in USA. Privia Health is a technology-driven national physician enablement company focused on optimizing physician practices and improving patient experiences. The Payer Contracting Analyst plays a crucial role in supporting the Payer Contracting team by analyzing and optimizing payer contracts, developing reports, and providing data-driven insights to guide strategic decision-making. Responsibilities • Conduct quantitative analyses to evaluate payer performance, utilization trends, bolthires 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 experience, preferably within a healthcare environment • Experience using SQL • Strong bolthires 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 • 1+ years experience working with healthcare claims data Benefits • Medical • Dental • Vision • Life • Pet insurance • 401K • Paid time off • Other wellness programs 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 Apply tot his job