Payor Relations Analysis

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The pay range for this position is $28.71 - $44.86 based on direct and relevant experience.

RAYUS Radiology is looking for a Payor Contract Rate Modeler to join our team. We are challenging the status quo by shining light on radiology and making it a critical first step in diagnosis and proper treatment. Come join us and shine brighter together! As a Payor Contract Rate Modeler, you will be responsible for analyzing historical data and variable inputs to develop financial models that provide innovative, thorough and practical solutions to support business opportunities. Partners with others inside the organization to explain models and review trends related to their performance. This a 100% remote full-time position working 40 hours per week. Shifts are from 8: AM - 5:00 PM.

ESSENTIAL DUTIES AND RESPONSBILITIES:

(80%) Payor Contracting Analytics

• Reviews proposed contract rates and develops mathematical models to forecast their financial impact on the organization based on historical performance and assumptions about future conditions.
• Understand relevant business context to properly interpret model results and make adjustments when reviewing performance.
• Maintains a consistent and logical process through all models to facilitate collaboration with others.
• Tests model sensitivity through a variety of scenarios and financial variables to determine revenue potential based on the model's assumptions. Incorporates additional stress testing of extreme scenarios to ensure model's validity in a range of scenarios.
• Analyzes year-over-year trends in the impact of rates and other variables in models.
• Develops "post mortem" analyses of how well models tracked with actual business outcomes based on revenues received from contracts.

(10%) Payor Contract Collaboration

• Clearly and concisely communicates technical subject matter, including methodology used in developing models, to internal partners in order to facilitate their understanding of how variables impact the model.
• Collaborates with members of the Payor Contracts team to help identify opportunities to maximize outcomes in negotiations with third party payor organizations.
• Provides appropriate updates to management and Payor Contracts team regarding development and adjustment of models.
• Promptly escalates issues as necessary to ensure internal partners have needed information on a timely basis.

(5%) Database Maintenance

• Maintains database of models, as well as contracts and other supporting documents needed for each model. Updates this information as needed as new versions of models are developed and new documentation is received.
• Seeks to continually improvement team processes and introduce efficiencies while maintaining quality and meeting expectations of deliverables.

(5%) Completes other tasks and projects as assigned

Required:

• Bachelor's Degree or equivalent experience
• 3-5 years analytical work experience
• Proficient with Microsoft Office Suite, including intermediate to advanced Excel skills
• Demonstrated organizational and analytical skills

Preferred:

• Previous medical revenue cycle management experience including knowledge of various payors; i.e. HMO's, PPO's, TPA's Workers' Compensation carriers, Managed Care Plans Commercial/Indemnity carriers, Auto carriers, etc.
• Basic understanding of SQL queries

RAYUS is committed to delivering clinical excellence in communities across the U.S., driven by our passion for and superior service to referring providers and patients. RAYUS Radiology is built on our brilliant medicine, brilliant team, brilliant technology and services - all to provide the highest level of patient care possible.

We bring brilliance to health and wellness. Join our team and shine the light on Radiology Services! RAYUS Radiology is an EO Employer/Vets/Disabled.

We offer benefits (based on eligibility) including medical, dental and vision insurance, 401k with company match, life and disability insurance, tuition reimbursement, adoption assistance, pet insurance, PTO and holiday pay and many more! Visit our career page to see them all www.rayusradiology.com/careers.