Senior Payer Strategy Analyst Job at Baptist Health (Florida) (Jacksonville)

Senior Analyst of Strategic Analytics

The Senior Analyst of Strategic Analytics is responsible for supporting the orga...

Location

United States , Phoenix

Salary:

109000.00 - 128000.00 USD / Year

Atlas Healthcare Partners

Expiration Date

Until further notice

Requirements

Requires a Bachelor’s degree in Business, Finance or related field
Requires a proficiency level typically attained with 4 or more years’ experience in Managed Care or Healthcare analytics preferred
Requires strong interpersonal, leadership and communication/presentation skills

Job Responsibility

Ability to assess and evaluate the financial impact results of managed care contract reimbursement rates and terms while being able to clearly articulate the results to leadership
Ability to prepare, clean and manipulate large datasets to prepare for evaluating volume, revenue/reimbursement across multiple payors
Analyzes, evaluates, and prepares contract rates and terms when needed through various payer proposals and counter proposals during negotiations
Supports JV health systems managed care contracting teams through developing financial models and rates to assist in the strategy and negotiations
Conducts adhoc analyses to address emergent issues and in support of stakeholder
Perform analyses to assist in developing the story to explain how ASC’s are performing while being able to identify trends and opportunities
Assists in developing new processes and tools to support our growing organization
Assists in business development analytics to forecast volume and revenue projections related to acquisitions, de novo’s across our health system partners
Develop statistical, economic, and financial analyses from data to evaluate performance and drive relevant business or clinical initiatives. Analyze data for trends, observations, improvements and make recommendations
Monitors, analyze, trends, reports and implements actions to improve operational KPI metrics

What we offer

industry-leading health and dental benefits
matching retirement package

Fulltime

Clinician Service Analyst Senior

Senior role within Clinician Services for Medical Specialties, focusing on codin...

Location

United States , Milwaukee

Salary:

38.20 - 57.30 USD / Hour

Advocate Aurora Health

Expiration Date

Until further notice

Requirements

Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) certification, or Coding Specialist (CCS) certification, or Coding Specialist – Physician (CCS-P) certification issued by the American Health Information Management Association (AHIMA) or Professional Coder (CPC) certification issued by the American Academy of Professional Coders (AAPC)
Specialty credential required
Completion of advanced training through a recognized or accredited program, equivalent in scope and rigor to post-secondary education or equivalent knowledge
High school diploma or GED required
5 years of experience in expert-level professional and/or facility coding, and experience in collaborating with other teams within an organization, and/or educating/training licensed clinicians
Advanced level of ICD-10- CM/PCS and/or ICD-10-CM/CPT/HCPCS for a large complex health care system or medical group
Extensive knowledge of third-party reimbursement programs, state and federal regulatory issues, national and local coverage determinants, research-related restrictions, ICD-10 CM/PCS, and CPT/HCPCS coding classifications
Proficiency in statistical analysis
Demonstrated proficiency in the Microsoft Office Suite (Word, Excel, PowerPoint, Teams, etc.) or similar products and in patient accounting and billing systems
Ability to deal and work effectively with multiple departments and in matrix organizational structures

Job Responsibility

Monitor and analyze KPIs to identify trends and transform data into actionable reports and presentations that support strategic decision-making
May participate in Service Line leadership meetings to represent Clinician Services, share updates, propose improvements, and align departmental efforts with organizational strategy
Collaborate with leadership and cross-functional teams—including Coding, CDI, CMD, Integrity Operations, Optimization & Technology, and Clinical Informatics—to identify improvement opportunities and advance documentation practices
Provide operational and technical guidance to staff and stakeholders, ensuring clarity and consistency in documentation and coding processes
Demonstrate compliance with regulatory requirements, including CMS, QIOs, NCCI edits, and payer-specific guidelines, while adhering to AHIMA’s Standards of Ethical Coding
Utilize EHR systems and coding tools proficiently, maintaining data integrity and supporting efficient documentation workflows
Maintains confidentiality of patient records
Reports any perceived non-compliant practices to the Clinician Services leadership or compliance officer
Engage in continuous learning, staying current with evolving coding guidelines, practices, and terminology through training and professional development
Promote a collaborative, service-oriented culture, modeling professionalism and teamwork across Clinician Services and organizational stakeholders

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Opportunity for annual increases based on performance
Premium pay such as shift, on call, and more
Incentive pay for select positions

Fulltime

Manager / Director Business Analytics

We are looking for Job Title: Manager / Director Business Analytics. We are seek...

Location

United States

Salary:

Not provided

SpectraMedix

Expiration Date

Until further notice

Requirements

12+ years of experience in healthcare analytics, management consulting, actuarial consulting, payer strategy, or value-based care environments
Deep knowledge of healthcare economics, payer operations, and value-based care performance drivers
Strong understanding of HEDIS, NCQA, Stars, risk adjustment, utilization management, and provider incentive models
Proven ability to analyze large healthcare datasets including claims, pharmacy, eligibility, provider, and clinical data
Strong financial modeling skills including ROI, PMPM analysis, trend forecasting, and scenario modeling
Experience presenting to executive audiences and influencing senior stakeholders
Demonstrated success leading complex client engagements and delivering measurable outcomes
Experience managing teams, developing talent, and overseeing high-quality work product
Strong technical fluency with SQL, Excel, and BI platforms such as Tableau or Microsoft Power BI
Excellent written and verbal communication skills with strong executive presence

Job Responsibility

Strategic Client Advisory: Serve as a trusted advisor to executive client stakeholders across analytics, network, finance, quality, and value-based care functions
Translate complex performance data into clear strategic recommendations tied to quality improvement, MLR performance, provider engagement, and financial outcomes
Lead executive presentations, steering committees and high-impact client discussions
Identify growth opportunities, operational risks, and emerging market trends affecting client performance
Value-Based Care Leadership: Demonstrated experience navigating the intricacies of VBC contract language (e.g., attribution logic, risk adjustment factors, and benchmark methodology)
Advise clients on value-based care models including pay-for-performance, shared savings, downside risk, capitation, and incentive programs
Interpret HEDIS, NCQA, Stars, risk adjustment, and utilization metrics within the context of provider contracts and health plan economics
Delivery Excellence & Scalable Execution: Establish rigorous standards for data quality, reconciliation, methodology transparency, and audit readiness
Build repeatable reporting frameworks, templates, and scalable processes that improve efficiency and consistency
Identify automation opportunities across recurring reporting, dashboard production, and insight generation

Fulltime

Managed Care Senior Manager

Corporate level manager responsible for deploying and contributing to strategic ...

Location

United States , Fort Lauderdale

Salary:

Not provided

Memorial Healthcare System

Expiration Date

Until further notice

Requirements

Bachelors
Five (5) years contracting experience with three (3) years contracting for hospital, professional services, ancillary facilities or specialty networks

Job Responsibility

Execute, contribute and manage complex legal, financial and operational contract language negotiations in concert with the Director of Managed Care or independently as applicable to the negotiation
Execute contracting strategies for all service lines in Memorial Hospitals, MHS employed physicians, transplant programs, and ancillary services of the fully integrated healthcare delivery system and its joint owned or joint ventured entities for fee for service and value based arrangements
Direct and analyze financial performance, reports and models, quality metrics and cost savings for negotiations with national and regional payors
Plan and monitor activities of staff and team members including hiring, orienting, training, mentoring, continuing education, evaluating, coaching and disciplinary actions
Enhance, estimate and preserve net revenues
Assure financial viability of contracts through financial analysis and forecasting in conjunction with Financial Analyst(s), contract negotiations and issue resolution
Execute strategies and guides operations to protect and build market share
Interface with managed care plans on claim reconciliations, trended issues and operational projects
Determine root cause and seek resolution
Evaluate payor assessments of overpayments and effectively dispute or resolve for settlement

Fulltime

Lead Business Analyst

Carex is partnering with a Health Insurance industry partner to find a Lead Busi...

Location

United States , Madison

Salary:

Not provided

Carex Consulting Group

Expiration Date

Until further notice

Requirements

Bachelor’s degree with 6+ years of experience in EHR and HIE technologies, OR associate degree with 9+ years, OR high school equivalency with 12+ years of relevant experience
Strong expertise in healthcare data standards such as HL7 v2/v3, FHIR, CDA, and CCD
Experience working with Epic systems, including payer platforms such as Tapestry and Compass Rose
Demonstrated ability to lead cross-functional teams and manage complex technical projects
Strong understanding of healthcare IT systems, data integration, and interoperability frameworks
Proven analytical and technical problem-solving skills, including ability to interpret complex regulatory documentation
Excellent communication and stakeholder engagement skills across technical and non-technical audiences
Experience with technical architecture, process design, and project management methodologies
Ability to manage multiple priorities in a fast-paced, evolving environment
Self-directed approach with strong organizational and documentation skills

Job Responsibility

Lead the development and execution of interoperability strategy aligned with organizational goals and regulatory requirements
Drive cross-functional initiatives that improve operational efficiency and ensure compliance across systems and data exchanges
Define and manage project roadmaps, ensuring timely delivery of key milestones and strategic objectives
Collaborate with internal stakeholders, external vendors, government agencies, and partners to support seamless integration efforts
Provide regular updates to senior leadership on program progress, risks, and performance outcomes
Identify and mitigate risks related to system integration, regulatory compliance, and data security
Establish and enforce governance frameworks, policies, and procedures for secure healthcare data exchange
Monitor regulatory changes and assess their impact on systems and processes, ensuring alignment with evolving requirements
Partner with IT and cybersecurity teams to implement secure data protocols, including encryption and access controls
Maintain detailed documentation including workflows, technical specifications, compliance records, and risk assessments

Principal Analyst, Customer Insights

The Principal Analyst, Customer Insights is a senior individual contributor resp...

Location

Salary:

Not provided

The Muse

Expiration Date

Until further notice

Requirements

8–10+ years of healthcare analytics experience, with strong payer experience preferred
Deep expertise in medical economics, claims data analysis, quality performance measurement, and value-based care
Advanced SQL proficiency, including optimization of complex queries in large data environments
Experience designing analytic methodologies and scalable frameworks
Demonstrated success influencing senior or executive stakeholders
Proven experience leading large, complex analytic initiatives with significant business impact
Strong data storytelling and executive-level communication skills
Experience mentoring and elevating senior analytic talent

Job Responsibility

Define and lead analytic strategy across large-scale, high-visibility customer engagements
Architect advanced analytic frameworks supporting medical economics, performance measurement, population health, and value-based care initiatives
Serve as the senior-most analytic escalation point for complex methodological or data integrity questions
Translate contractual requirements and strategic objectives into measurable analytic roadmaps
Drive cross-functional alignment across Product, Engineering, Actuarial, Data Science, Finance, and Customer Success
Ensure technical excellence and rigor in all analytic deliverables
establish quality standards and governance practices
Identify scalable opportunities for automation, reusable intellectual property, and analytic innovation
Present insights and strategic recommendations to senior and executive-level stakeholders
Mentor and develop Lead, Senior, and Data Analysts, elevating analytic capability across the team

What we offer

Pet Insurance
Health Insurance
Dental Insurance
Vision Insurance
FSA
HSA
HSA With Employer Contribution
Life Insurance
Short-Term Disability
Long-Term Disability

New

Forklift Operator

Location

United States , Bohemia

Salary:

20.64 USD / Hour

Nestle Health Science

Expiration Date

Until further notice

Requirements

High school diploma or GED preferred
1+ years of experience in manufacturing or warehouse operations
Ability to obtain forklift certification
Proven experience operating forklifts and warehouse equipment
Able to lift up to 50 lbs and move throughout your shift
Comfortable working around powders, chemicals, and food allergens
Flexible to work overtime based on business needs

Job Responsibility

Operate forklifts and material handling equipment safely
Load and unload trucks, verifying shipments against documentation
Perform cycle counts and update inventory systems
Organize and label warehouse storage areas
Pick, pack, and stage materials for shipment
Inspect equipment and report maintenance needs
Collaborate with team members to prioritize tasks and maintain workflow
Follow safety rules, Good Manufacturing Practices (GMPs), Standard Operating Procedures (SOPs), and company policies
Perform other duties as assigned

What we offer

Performance-based incentives
401k with company match
Healthcare coverage
Broad range of other benefits

Fulltime

New

Support Worker

We are currently recruiting for a Support Worker to join our team at Shelton Car...

Location

United Kingdom , Stoke-on-Trent

Salary:

12.91 GBP / Hour

National Care Group

Expiration Date

Until further notice

Requirements

A caring attitude, with a passion for supporting others and a motivation to see them achieve goals
A team player, able to work effectively with other colleagues
Resilience to keep going at difficult times and the confidence to ask for support if needed
Excellent listening and communication skills

Job Responsibility

Build positive relationships with people by listening, discussing, and then planning goals and ambitions together
Help to plan daily tasks and assist with practical activities such as cooking, cleaning and running errands
Assist with personal care, which may include support with eating and administering medication
Help to plan and participate in any exciting days out they wish to enjoy
Make a positive impact on someone’s life by supporting them to become more independent wherever possible

What we offer

The opportunity to develop a career in a secure and fulfilling role at an organisation that values growing its team from within
Continuously learn on the job with the benefit of paid training and the opportunity to gain recognised qualifications
Work at an organisation that celebrates age, gender and diversity within an inclusive culture
The organisation promotes an environment of wellbeing with support for you to stay healthy and happy
The opportunity to earn rewards through a Refer a Friend scheme
Access to Stream (Formerly Wagestream), enabling greater control over your finances

Fulltime

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Senior Payer Strategy Analyst

Job Description

Job Responsibility

Requirements

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