The Payer Analytics Consultant is a strategic partner and subject matter expert in payer data analytics, driving actionable insights that directly influence INTEGRIS Health’s network strategy, value-based care initiatives, and financial performance. This role leverages advanced analytics, financial modeling, and data visualization to evaluate payer performance, optimize reimbursement strategies, and identify opportunities for cost containment and quality improvement. The Consultant collaborates closely with executive leadership, clinical teams, and payer relations to inform high-impact decisions, enhance patient care, and ensure regulatory compliance, including HIPAA.
INTEGRIS Health is an Equal Opportunity/Affirmative Action Employer.
Minimum of 5 years of progressive experience in analytics, payer contracting, or financial modeling, ideally within a health system or payer environment.
Proven expertise in advanced analytics, financial modeling, and healthcare reimbursement methodologies.
Deep understanding of healthcare payer-provider dynamics, claims data, and quality metrics.
Demonstrated ability to lead complex projects, manage multiple priorities, and deliver high-impact, strategic recommendations.
- Bachelor’s degree in Business, Data Analytics, Finance, Healthcare Administration, or a related field
SKILLS: Strong proficiency with SQL, Microsoft Excel, and data visualization tools (e.g., Tableau, Power BI).
Exceptional communication and influencing skills with the ability to present complex analyses to executive leadership.
The Payer Analytics Consultant responsibilities include, but are not limited to, the following:
Serve as a strategic advisor on payer performance and reimbursement strategies, translating complex claims and financial data into actionable insights.
Lead advanced data analyses to identify trends in cost, utilization, and payer performance, driving recommendations for network optimization and contract negotiations.
Develop and maintain comprehensive scorecards, dashboards, and financial models to track key performance indicators, value-based care outcomes, and quality metrics.
Partner with clinical and operational leadership to identify opportunities to improve patient outcomes, operational efficiency, and financial performance.
Provide high-level recommendations for payer strategies, including value-based contact negotiations, utilization management, and quality improvement initiatives.
Ensure timely, accurate reporting and visualization of key analytics to support strategic decision-making at the executive level.
Drive initiatives to reduce healthcare costs through data-informed interventions, including optimizing care delivery, enhancing payer-provider alignment, and improving claims processing efficiency.
Act as a thought leader on healthcare analytics, keeping abreast of emerging trends in payer dynamics, reimbursement methodologies, and regulatory requirements.
Working Conditions:
May sit up to 90% of the day
May utilize a computer keyboard up to 6-8 hours per day
May have additional or varied physical demand and/or respiratory fit test requirements
All applicants will receive consideration regardless of membership in any protect status as defined by applicable state or federal law, including projected veteran or disability status
Office environment with typical working hours; some overtime may be required during peak reporting periods.
Reports to the department director.