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Tribunus Health

Tribunus Health

Managed Care Payer Contract Analyst

Full-TimeUpdated on 9/18/2026
$90k - $125k/yr

+ Annual performance bonus

Senior
Bachelor's
Remote in USA+2 more

More locations: Washington, DC, USA | Charlottesville, VA, USA

Hybrid

The role may be performed remotely or from hubs in Charlottesville, Washington, D.C., and Philadelphia; Philadelphia is mentioned as a hub but not in the raw ATS locations.

About the job

Requirements
  • A Bachelor's Degree in Finance, Healthcare Administration, Business, or a related field is required.
  • At least 5 years of experience in payer-related roles within the provider or insurance industry, including at least 3 years in net revenue reimbursement modeling, financial analysis, and performance computation.
  • Hospital contract modeling experience is required, including building expected-reimbursement logic from contracts and working with models created by clients or payers.
  • Professional fee schedule modeling experience is required.
  • Proficiency in contracting analytics and the ability to use reimbursement data to inform decisions and assess a provider's value relative to competitors.
  • Intermediate to advanced capabilities with Microsoft Excel and PowerPoint, experience building and manipulating contract modeling tools, and experience extracting data from online databases such as price-transparency databases.
  • Strong project management, attention to detail, conceptualization, and logic skills.
  • Strong written and verbal communication skills, including an internal customer-service orientation.
Responsibilities
  • Translate contract language into expected reimbursement and build flexible models that support scenario development.
  • Build models covering hospital reimbursement methodologies such as DRG case rates, tiered per diems, percent-of-charge, APC and EAPG outpatient methodologies, implant and high-cost drug carve-outs, stoploss, outlier, and lesser-of-charges provisions.
  • Build models covering professional conversion-factor and fee-schedule arrangements, aggregating fee-for-service and value-based data from multiple sources.
  • Serve as an expert resource and trainer for colleagues on hospital and professional reimbursement methodologies and fee-schedule analysis.
  • Lead relationships with applicable data vendors, including price-transparency and claim-utilization vendors, and disseminate updates and functionality improvements.
  • Analyze contracts and historical reimbursements to inform strategy and shape contract proposals.
  • Validate payer rate loads to ensure contracts are executed accurately and perform root-cause analysis of variances when included in a client engagement.
  • Monitor payer policy updates and quantify the impact of potential material harm and other contract implications.
  • Support company leadership with ad hoc projects and update internal tracking systems as analytical work is completed.

About the company

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