医疗保障支付方合同分析师
Managed Care Payer Contract Analyst
关于Tribunus Health
在2025年和2026年均被Modern Healthcare评为“最佳工作场所”的Tribunus Health与领先的医疗集团和其他医疗机构合作,提升财务表现和运营效率,专注于支付方合同、报销优化和高接触客户支持。我们的客户将最关键的收入流程交给我们。我们通过积极主动、数据驱动和始终以客户为中心来维护这份信任。
Tribunus正在快速成长,为组织中各个层级的有才华的人士提供大量机会,让他们影响业务并获得更多的责任。
职位描述
Payer Contract Analyst是我们在工作中分析的核心力量,为多种Tribunus账户提供关键洞察。分析师的任务是进行稳健的情景建模,并利用报销数据来支持管理护理合同谈判,监控合同表现,评估行业趋势和政府法规的影响。你将与Tribunus团队成员紧密合作,了解他们的需求,并作为值得信赖的分析交付合作伙伴,帮助最大化谈判成果。
理想的候选人应在其职业生涯中展示过使用所有可用数据资产回答相关业务问题的能力,并在个人和团队环境中实现目标结果。需要在医院环境中进行合同分析的经验。如果你曾经需要决定停损条款是在费用较少比较之前还是之后适用,那么这个职位会感觉很熟悉。
我们希望有人全职加入我们的团队,但也愿意讨论兼职情况。地点灵活,许多员工远程办公,同时在弗吉尼亚州夏洛茨维尔、华盛顿特区和宾夕法尼亚州费城设有办公点。
你将负责以下工作,与Tribunus团队成员一起:
- 合同与情景建模:将合同语言转化为预期的报销,并构建灵活的模型以支持情景开发。我们的医院工作涵盖DRG病例费率、分层每日费用、按费用百分比、APC和EAPG门诊方法、植入物和高成本药物剥离条款,以及停损、异常值和费用较少比较条款;我们的专业工作涵盖转换因子和费用表安排。模型整合基于服务收费和价值-based的数据从m
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About Tribunus Health
Recognized in both 2025 and 2026 on Modern Healthcare's ‘Best Places to Work,’ Tribunus Health partners with leading medical groups and other healthcare organizations to improve financial performance and operational efficiency—specializing in payer contracting, reimbursement optimization, and high-touch client service. Our clients trust us with their most mission-critical revenue processes. We honor that trust by being proactive, data-driven, and relentlessly client-focused.
Tribunus is growing quickly, offering ample opportunities for talented individuals at all levels of the organization to impact the business and earn more responsibility.
The Role
The Payer Contract Analyst is the analytical engine behind our work, providing crucial insights to support a variety of Tribunus accounts. The Analyst's mission is to perform robust scenario modeling and harness reimbursement data to inform managed care contract negotiations, monitor contract performance, and assess the impact of industry trends and government regulations. You will collaborate closely with Tribunus team members to understand their needs and act as a trusted analytics delivery partner to help maximize negotiation outcomes.
The ideal candidate will have, throughout their career, demonstrated the ability to answer pertinent business questions using all available data assets and achieve targeted outcomes both individually and in team settings. Experience performing contract analytics in a hospital setting is required. If you have had to decide whether stoploss applies before or after the lesser-of-charges comparison, this role will feel familiar.
We are looking for someone to join our team in a full-time capacity, but are open to discussing part-time scenarios. Location is flexible, with many individuals remote and hubs in Charlottesville, VA, Washington D.C., and Philadelphia, PA.
What You’ll Do
Responsibilities include facilitating the following alongside Tribunus team members:
- Contract & Scenario Modeling: Translate contract language into expected reimbursement and build flexible models that support scenario development. Our hospital work spans DRG case rates, tiered per diems, percent-of-charge, APC and EAPG outpatient methodologies, implant and high-cost drug carve-outs, and stoploss, outlier, and lesser-of-charges provisions; our professional work spans conversion-factor and fee schedule arrangements. Models aggregate fee-for-service and value-based data from multiple sources.
- Training and Support: Serve as an expert resource and trainer for colleagues on hospital and professional reimbursement methodologies and fee schedule analysis.
- Data Vendor Lead: Lead relationships with applicable data vendors (price transparency, claim utilization, etc.) and disseminate information about updates and functionality improvements.
- Strategic Data Utilization: Analyze contracts and historical reimbursements to inform strategy and shape contract proposals.
- Performance Monitoring: When included in a client engagement, validate payer rate loads to ensure contracts are being executed accurately and perform root-cause analysis of variances.
- Market & Policy Research: Monitor payer policy updates and quantify the impact of potential material harm and other contract implications.
- Cross-Functional Support: Serve as a resource to company leadership to assist in ad-hoc projects and update internal tracking systems as analytical work is completed.
Qualifications
You have the following experience and proven skillsets:
- Bachelor’s Degree Finance, Healthcare Administration, Business or related field.
- 5+ years in payer-related roles within the provider or insurance industry, including at least 3 years in net revenue reimbursement modeling, financial analysis, and performance computation.
- Hospital contract modeling experience is required. You should be equally comfortable building expected-reimbursement logic from a contract and working inside a model you didn't write — including one a client or a payer built to support their own number. Professional fee schedule modeling experience is also required.
- Proficiency in contracting analytics, with the ability to harness reimbursement data to inform decisions and quickly assess a provider's value relative to its competitors.
- Intermediate to advanced capabilities with Microsoft Excel and PowerPoint, along with experience building and manipulating Contract Modeling tools and extracting data from online databases (price transparency, etc.).
- Strong project management skills, excellent attention to detail, and efficient conceptualization and logic skills.
- Excellent written and verbal communication skills, including strong internal customer service orientation.
Compensation & Structure
We are committed to transparency and equity in our hiring process and offer competitive benefits.
- Expected Base Salary range: $90,000 - $125,000. In compliance with wage transparency laws in many of the jurisdictions in which we recruit, we provide this information. Note that all salary ranges are subject to adjustment based on experience, education, location and other factors relevant to the position.
- Performance Bonus: Eligible for additional annual performance bonus based on organizational scaling metrics.
- Flexibility: We are open to part-time and hourly arrangements.
- Benefits: For full-time individuals, additional benefits include a comprehensive medical benefits package and employer contribution to a 401k plan.
What Makes Tribunus Health Different
Our people are our edge. We’re a mission-driven, high-performing team that works hard, learns fast, and shows up for one another. We believe in clear communication, mutual respect, and doing work that has real impact—for our clients and the healthcare system.
We live by these values:
- Candor: We believe that honesty is empowering.
- Bias for action: We are solutions oriented.
- Collaboration: We are committed to client success.
- Expertise: We develop a deep understanding of our industry, clients, landscape.
- Innovation: We strive to be the first to know and first to act.
Equal Opportunity Employer
Tribunus Health is proud to be an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
Originally posted on Himalayas