[Remote] Payer Contracting Analyst

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