Payer Contract Analyst

Job Summary

The Payer Contracts Analyst provides technical support, and departmental analysis, as it pertains to payer professional contract rates and reimbursement policies. Technical leader with a high degree of operational knowledge and technical expertise in professional reimbursement and contracting. Must be able to function with a high degree of autonomy, with ability to collaborate with other technical analysts as needed.

Apply By Date: 2/15/2026 at 11:59 pm - Interviews and recruiting process may occur at any time

Minimum Qualifications - For full consideration, applicants are encouraged to upload license and/or certification if required of the position

• EPIC Certification
• Bachelor's degree in a related field preferred or equivalent combination of education and experience within a healthcare facility.
• Extensive experience in at least 2 of the following Epic Modules; EMR, Resolute, ADT, Cadence, Tapestry, Clarity and Reporting Workbench
• Ability to interpret and understand third party payer contracts, terms and regulations.
• In-depth knowledge of third party payer contracts, contracting processes and procedures and regulations governing third party payers, including capitated managed care contracting issues and the relationships between health plans and medical groups.
• Technical knowledge of all licensed health care service plans, including State and Federal plans, billing policies and procedures and the ability to recognize when they are not being followed.
• In-depth knowledge of the practices, procedures, and concepts of the healthcare revenue cycle and its component operations, including billing, collections, charge capture, contractual adjustments, third-party reimbursements, and cash management.
• In-depth understanding of the issues, processes, reporting instruments, metrics, dashboard design, and other tools and techniques involved with measuring and analyzing the revenue cycle and reimbursement.
• Advanced skills in report development, dashboard design, and various software tools specific to healthcare revenue cycle management. Skills in common database, spreadsheet and presentation software.
• Demonstrates professionalism, tact, courtesy and diplomacy in dealing with personnel at all levels in and outside of the health system
• Advanced communications skills, with the ability to interpret and convey complex clinical finance information in a clear, concise manner.
• Ability to prepare compelling and informative reports and presentations to all levels of staff and management.
• Strong ability to advise management, serving as a technical expert, providing proposals for improvement and guidance on regulatory changes and industry trends and developments in revenue cycle management.
• Knowledge and ability to apply mathematical and statistical methods, quantitative analyses, evaluative techniques, and business planning techniques.
• Ability to establish and maintain effective and appropriate working relationships with co-workers, subordinates and others, exhibiting assertiveness, a realistic perspective, objectivity, courtesy and awareness of how his/her actions affect others.

Preferred Qualifications

• EPIC PB Contracts Module
• Experience with UCDHS tables and software applications;
  Business Objects, Enterprise Finance Analytics, Page Center X and NHXS.
• Advanced PC spreadsheet skills including mastery of:
  Excel macros, modeling, pivot tables, lookup tables, logical functions, charting and spreadsheet troubleshooting.
• Advanced analytical and problem-solving skills, with the ability to evaluate the effectiveness of workflows and systems in revenue cycle program areas, to identify weaknesses and develop innovative solutions and process improvements.
• Experience, knowledge, and certification with PB Contracts Module.

Key Responsibilities

• 60% - Provide Technical Systems Build and Support
• 20% - Provide Contracts Performance Analysis
• 20% - Maintain/Support Payer Relations

Department Overview

The Professional Billing Group (PBG) provides billing and collection services for approximately 1,200+ UCD School of Medicine faculty physicians and other providers. The purpose of this position is to provide technical support, and departmental analysis, as it pertains to payer professional contract rates and reimbursement policies. Technical leader with a high degree of operational knowledge and technical expertise in professional reimbursement and contracting.

Must be able to function with a high degree of autonomy, with ability to collaborate with other technical analysts as needed. Analyst responsibilities include performing regular maintenance of the EPIC PB Contracts Module, building new PB contract templates in EPIC as needed, monitoring payer contract performance and escalating to appropriate parties when payer is underperforming according to contract, performing both pro-active and ad hoc payer reimbursement analyses to ensure timely and appropriate professional reimbursement.

Collaborates with other departmental analysts to solve complex problems that…