Note: The job is a remote job and is open to candidates in USA. Privia Health is a technology-driven, national physician enablement company that aims to optimize physician practices and improve patient experiences. The Payer Contracting Analyst will contribute to the Payer Contracting team by analyzing and optimizing payer contracts, delivering data-driven insights, and collaborating with various departments to support strategic decision-making.
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 experience, preferably within a healthcare environment
- 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
- 1+ years experience working with healthcare claims data preferred
Benefits
- Medical, dental, vision, life, and 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 http://www.priviahealth.com.
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