Senior Healthcare Payer Performance Analyst

Job Family:
Business Systems Analysis

Travel Required:

Up to 10%

Clearance Required:

None

• Analyze complex physician, facility, and ancillary contract terms, claims data, fee schedules, and reimbursement outcomes to support contract management, modeling, performance monitoring, and issue resolution.
• Develop data-driven analyses to identify trends, variances, discrepancies, and financial or operational impacts related to payer contract performance and reimbursement accuracy.
• Perform root-cause analysis using contract requirements, claim details, payment data, and operational workflows to distinguish contract configuration, interpretation, reimbursement, and claims-processing issues.
• Use Excel and other business intelligence or analytics tools to organize, validate, interpret, summarize, and present complex healthcare data in support of reporting, issue resolution, and decision-making.
• Lead analysis work streams, synthesize findings, prepare clear deliverables, and present conclusions and recommendations to internal stakeholders, operational leaders, and other audiences as needed.
• Partner with contracting, reimbursement, operations, analytics, and leadership teams to clarify requirements, resolve issues, and align contract terms, data outputs, and operational processes.
• Manage multiple priorities while maintaining a high degree of accuracy, attention to detail, sound judgment, and timely delivery in a data-intensive environment.

• Bachelor's degree in healthcare administration, business, finance, or a related field.
• 5-7+ years of experience in healthcare data analysis, reimbursement analytics, contract management, managed care, revenue cycle, payer/provider contracting, or a related healthcare operations environment.
• Strong understanding of healthcare reimbursement concepts, provider and payer contract language, fee schedules, contract interpretation, and how contract terms translate into data and payment outcomes.
• Experience performing payment variance analysis, root-cause analysis, and issue resolution in a healthcare setting.
• Advanced analytical and critical-thinking skills, with the ability to evaluate large or complex data sets, identify actionable insights, and translate findings into practical recommendations.
• Strong knowledge of medical terminology and healthcare coding concepts, including CPT, HCPCS, ICD, and revenue codes.
• Advanced Microsoft Excel and Office proficiency, including experience organizing, analyzing, validating, summarizing, and presenting data; experience with business intelligence, reporting, or analytics tools is preferred.
• Excellent written, verbal, communication, and presentation skills, including the ability to lead discussions, present analytical findings, and explain complex contract, reimbursement, and data concepts clearly to non-technical stakeholders and leadership.
• Demonstrated ability to work independently, exercise sound judgment, manage high-complexity analytical assignments, and communicate risks, findings, and recommendations effectively.

• Experience with Fin Thrive.
• Experience with Epic

The annual salary range for this position is $89,000.00-$.

Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace. Benefits include:

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care
• Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program

Guidehouse is an Equal Opportunity Employer-Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance…