You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.
Job Summary
Our client is seeking an experienced Analytics Consultant to design and validate managed care payer models. This role involves performing moderately complex analyses to evaluate reimbursement methodologies and supporting the development of financial models. The objective is to prepare and present modeling results to key stakeholders and identify opportunities for payer reimbursement improvements.
Responsibilities / Job Duties
- Designs and validates managed care payer models, including supporting financial model development and payer performance analysis.
- Maintains models to identify implications of new strategies and rate structures aimed at ensuring appropriate reimbursement levels.
- Presents modeling results to senior leadership for decision-making, researching data for provider reimbursement analysis.
- Conducts financial analysis supporting payer reimbursement, monitors contract rates and reimbursement methodologies.
- Coordinates with internal and external stakeholders to achieve payer reimbursement objectives.
Minimum Education and Experience Qualification Requirements
Education
- Bachelor’s degree in Business Administration, Accounting, Finance, Healthcare, or a related field.
Qualifications
- 3+ years of experience performing financial healthcare reimbursement analysis.
- Experience with Medi-Cal, Medicare, and claims analysis.
- Proficiency in financial modeling, SQL, and data visualization tools like Tableau.
- Knowledge of CPT, HCPCS, and ICD 9/10 coding systems.
- Understanding of provider reimbursement methodologies and pricing for different provider types.
Preferred Skills
- A Master’s degree may substitute for two years of the required experience.
Skills
- Strong analytical and problem-solving abilities.
- Excellent communication and presentation skills.
Schedule / Shift
Monday - Friday 8am-5pm PST
Benefits
- Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
- Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
- 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
- Short Term Disability Insurance.
- Term Life Insurance Plan.
Required Employment / Compliance Language
- Medix provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics.
*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
Medix Overview:
With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
*As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients
