What you will accomplish in this roleThe Senior Data Analyst - Payer Contracting & Analytics is responsible for analyzing payer contract, reimbursement, claims, and financial performance data to support managed care and payer contracting initiatives across the organization. This role partners closely with Managed Care, Revenue Cycle, Finance, and Operational leaders to develop actionable insights that support contract negotiations, reimbursement optimization, payer performance monitoring, and strategic decision-making.
The successful candidate will leverage healthcare claims, reimbursement, contractual, and operational data to identify trends, opportunities, and risks related to payer agreements. This individual will develop metrics and reporting solutions that measure contract performance, evaluate reimbursement outcomes, and support financial forecasting initiatives. The role serves as a subject matter expert on payer-related data within HCA Healthcare Intelligence Net (HIN) and helps ensure data quality, integrity, and standardization across reporting platforms.
Success in this role requires a strong understanding of healthcare reimbursement methodologies, payer contracts, managed care operations, healthcare financial analytics, and the ability to translate complex data into meaningful business insights. The ideal candidate will possess a combination of strong analytical capabilities, technical expertise, and exceptional communication skills.
Major Responsibilities- Analyze payer contract, reimbursement, claims, and financial performance data to identify trends, opportunities, and areas for revenue optimization.
- Develop and maintain dashboards, scorecards, and key performance indicators (KPIs) related to payer performance, reimbursement rates, contract compliance, and revenue cycle outcomes.
- Support payer contract negotiations through financial modeling, contract valuation analysis, reimbursement benchmarking, and scenario modeling.
- Collaborate with Managed Care, Revenue Cycle, Finance, and operational stakeholders to define reporting requirements and performance metrics.
- Monitor payer contract effectiveness and provide recommendations to improve reimbursement performance and contract strategy.
- Perform detailed analyses of denial trends, underpayments, payer mix, utilization patterns, and reimbursement variances.
- Coordinate data requirements from business partners and assess the usefulness, reliability, and quality of data from multiple healthcare systems.
- Develop and maintain documentation related to payer data sources, business rules, data lineage, and reporting methodologies.
- Ensure payer and reimbursement data is presented accurately within business intelligence solutions and enterprise reporting tools.
- Work with source system teams to understand data intent, contract configuration, reimbursement methodologies, and data integration requirements.
- Support data quality initiatives by identifying data discrepancies and developing solutions to improve accuracy and standardization.
- Participate in data modeling discussions, reporting design reviews, and testing of analytic solutions.
- Perform advanced data profiling and validation to ensure data integrity across payer-related reporting environments.
- Present findings and recommendations to business leaders, supporting strategic decisions related to payer contracting and managed care initiatives.
- Strong analytical and technical skills with the ability to assess financial impacts, identify risks, and recommend practical solutions.
Education & Experience- Bachelor's degree required.
- 5+ years of healthcare analytics, managed care, payer contracting, reimbursement, revenue cycle, or related analytical experience required.
- 5+ years of experience working with healthcare claims, reimbursement, contract management, or financial data required.
- Experience supporting payer contract negotiations, reimbursement analysis, contract modeling, or managed care strategy preferred.
- Advanced experience with SQL Server, data warehousing, business intelligence tools, and healthcare reporting solutions preferred.
- Strong understanding of healthcare reimbursement methodologies including DRG, APC, fee-for-service, value-based care, and managed care payment models preferred.
- This is a hybrid role based in Nashville, TN.
At HCA Healthcare, we are committed to fostering a culture of growth that allows you to build the career of a lifetime. We encourage you to apply for our Senior Data Analyst today. We review all applications promptly, and qualified candidates will be contacted to continue the process. Join us!
