Top 93 medicare encounter data analyst Jobs in remote

Sr. Financial Analyst - Provider Contracts
CenCal Health —Remote
- $120,970 - $181,455 a year
- Full-time
- 5 years
- Finance
- SQL
- Health savings account
- Health insurance
Quick Apply
14d
Reimbursement Analyst- Audit and Regulatory
SYSTEM West Virginia University Health System —Remote
- Full-time
- Remote
- Microsoft Outlook
- Computer literacy
- English
Medicaid Researcher, Healthcare Innovations
American Institutes for Research —Chicago, IL
- $96,100 - $128,100 a year
- Email
- Remote
- Master's degree
- SQL
- Doctor of Philosophy
Lead Overpayment Recovery Analyst, Payment Integrity - Health Plan (Remote)
Molina Healthcare, Inc. —Columbus, GA
- $83,252 - $155,508 a year
- Full-time
- Remote
- Organizational skills
- Senior level
- 2 years
- Health insurance
14d
Senior Financial Analyst - Provider Contracts
CenCal Health —Santa Barbara, CA
- $120,970 - $181,455 a year
- Full-time
- Remote
- 3 years
- Finance
- SQL
6d
Senior Technical Product Manager (Clinical Data Platform), Remote
Aledade —Remote
- Full-time
- Remote
- Research
- 8 years
- Product management
- Paid parental leave
- Paid holidays
Quick Apply
Benefits Configuration Analyst
PHH Peak Health Holdings —Remote
- Full-time
- Research
- Mid-level
- Office
- Health insurance
1d
Associate Actuary (CMS Regulatory & Bid Pricing)
Curana Health —Remote
- Full-time
- SQL
- Analysis skills
- Bachelor's degree
Epic Sr. Analyst - Quality and Population Health
University of Miami —Miami, FL
- Weekends as needed
- Remote
- Mid-level
- Bachelor's degree
- Organizational skills
- Health insurance
- Dental insurance

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Lead Overpayment Recovery Analyst, Payment Integrity - Health Plan (Remote)
Molina Healthcare, Inc. —Columbus, OH
Assists with and executes projects and tasks to ensure Centers for Medicare and Medicaid Services (CMS) and state regulatory requirements are met for pre-pay…
$83,252 - $155,508 a year
14d

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medicare encounter data analyst jobs near remote

Sr. Financial Analyst - Provider Contracts

CenCal Health
Remote

Quick Apply

Job Details

Full-time
$120,970 - $181,455 a year
14 days ago

Benefits

Health savings account
Health insurance
Dental insurance
Flexible spending account
Paid time off
Employee assistance program
Vision insurance
Professional development assistance
Referral program
Retirement plan

Qualifications

Economics
Medicare
Managed care
Healthcare Administration
Financial analysis
Finance
SQL
Bachelor's degree
Health insurance knowledge
Query execution time improvement
Medicaid
Healthcare reimbursement methods
Query management
Accounting

Full Job Description

While candidates from anywhere in California are welcome to apply, there is a strong preference for those who reside on the Central Coast (Ventura, Santa Barbara, San Luis Obispo, Monterey and Santa Cruz Counties). This role may offer opportunities for remote work; however, familiarity with and proximity to our local customers is valued.

We are seeking a highly analytical and strategic Senior Financial Analyst – Provider Contracts to support the financial performance and reimbursement strategy of our Medicaid Managed Care and Medicare Advantage D-SNP health plans. This role is ideal for a healthcare finance professional with deep expertise in provider reimbursement, advanced SQL analytics, and value-based care modeling.

As a key subject matter expert, you will lead complex provider contract financial analysis, reimbursement rate development, and value-based payment modeling while partnering closely with Provider Contracting, Quality, Clinical, and Data Analytics teams to support data-driven decision-making and affordability initiatives.

What You’ll Do Provider Contract Financial Analysis

Perform detailed financial impact analyses for:
New provider contracts
Contract renewals and amendments
Rate adjustments and benefit changes
Value-based payment arrangements including shared savings, shared risk, and quality incentives
Analyze utilization, PMPM, unit cost, and total cost of care trends using healthcare claims and encounter data
Support reimbursement structures across Medicaid and Medicare lines of business including:
Fee-for-service (FFS)
Capitation
Value-based and hybrid payment models

Rate Development & Financial Modeling

Develop reimbursement methodologies including:
CPT/HCPCS, DRG, and APC fee schedules
Case rates, bundled payments, and per diems
Capitation and alternative payment models (APMs)
Build complex scenario-based financial models to support provider negotiations and executive decision-making
Design methodologies for:
Incentive pools
Risk corridors
Withholds
Shared savings/losses
Performance benchmarks and thresholds
Ensure all models align with CMS guidance, Medicaid managed care requirements, network adequacy standards, and affordability goals

Advanced SQL & Healthcare Data Analytics

Use advanced SQL to extract, transform, validate, and analyze large healthcare claims datasets
Develop custom datasets for:
Contract modeling
Reimbursement analysis
Value-based performance measurement
Analyze provider performance against quality, utilization, and cost metrics
Create reproducible and well-documented SQL queries and reporting methodologies
Partner with Data Analytics teams to ensure data integrity and reporting accuracy

Strategic Collaboration & Leadership

Support provider contract negotiations with data-backed financial insights
Collaborate cross-functionally with Provider Network, Quality, Clinical, and Finance teams
Present complex analytical findings in a clear and actionable manner to technical and non-technical audiences
Serve as a mentor and subject matter expert for junior analysts
Drive process improvements, automation, and standardization initiatives

What We’re Looking For Required Qualifications

Bachelor’s degree in Finance, Accounting, Economics, Healthcare Administration, or related field
Minimum 5 years of healthcare financial analysis experience
Minimum 3 years of provider reimbursement, payment modeling, or provider contract financial analysis experience
Experience supporting Medicaid Managed Care or Medicaid lines of business
Advanced SQL experience including:
Complex joins
Subqueries
Aggregations
Query optimization and performance-conscious design

Apply today and help shape the future of healthcare reimbursement and provider partnerships.

Pay: $120,970.00 - $181,455.00 per year

Benefits:

Dental insurance
Employee assistance program
Flexible spending account
Health insurance
Health savings account
Paid time off
Professional development assistance
Referral program
Retirement plan
Vision insurance

Work Location: Remote

Quick Apply

Refine Your Search

medicare encounter data analyst jobs in remote

Sr. Financial Analyst - Provider Contracts

Reimbursement Analyst- Audit and Regulatory

Medicaid Researcher, Healthcare Innovations

Lead Overpayment Recovery Analyst, Payment Integrity - Health Plan (Remote)

Senior Financial Analyst - Provider Contracts

Senior Technical Product Manager (Clinical Data Platform), Remote

Benefits Configuration Analyst

Associate Actuary (CMS Regulatory & Bid Pricing)

Epic Sr. Analyst - Quality and Population Health

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