13212 Enterprise Corporate - Managed Health Clinical insights & Operations: Contract Management
Full time
Yes
40
Schedule Details/Additional Information:
8am-5pm, M-F, Remote
Variability in hours based on various project requirements
Pay Range
$41.10 - $61.65
The Senior Analyst, Revenue Performance Optimization plays a critical role in driving sustainable revenue improvement through deep analysis of payer behavior, reimbursement methodologies, contract performance, and revenue cycle outcomes. This role partners closely with Revenue Cycle, Managed Care, Finance, and Clinical Operations to identify revenue leakage, optimize payer performance, reduce denials, and support strategic decision-making through data-driven insights.
The ideal candidate brings strong healthcare revenue cycle experience, a detailed understanding of payer policies and contract language, and the ability to translate complex findings into actionable recommendations.
Key Responsibilities
Revenue Performance & Optimization
- Analyze end-to-end revenue cycle performance to identify trends, risks, and opportunities related to reimbursement, underpayments, denials, and payer compliance.
- Perform variance analysis between expected and actual reimbursement based on contract terms, fee schedules, and payer policies.
- Develop and maintain revenue optimization models focused on yield, net revenue, and denial prevention.
- Track payer performance metrics and identify opportunities for contract optimization and renegotiation support.
Payer Policy & Contract Analysis
- Interpret payer policies, medical necessity criteria, reimbursement methodologies, and payment rules to assess revenue impact.
- Analyze payer contracts and amendments to ensure accurate modeling, payment validation, and compliance with negotiated terms.
- Partner with Managed Care and Legal teams to translate contract language into operational payment logic and analytics.
Denials & Underpayment Management
- Conduct root-cause analysis on denials and underpayments to identify systemic issues related to coding, authorization, documentation, billing, or payer behavior.
- Support development of denial prevention strategies and monitor effectiveness over time.
- Provide analytical support for appeals prioritization and payer escalation strategies.
Reporting, Insights & Stakeholder Support
- Design and deliver executive-level dashboards and reports highlighting revenue risks, payer trends, and optimization opportunities.
- Translate complex analytical findings into clear, actionable insights for non-technical stakeholders.
- Support revenue cycle initiatives, technology implementations, and performance improvement projects.
Leadership & Continuous Improvement
- Serve as a subject matter expert in revenue performance analytics, payer reimbursement, and denial analysis.
- Proactively identify opportunities to automate, streamline, and enhance revenue performance reporting and workflows.
Required Qualifications
Education
- Bachelor’s degree in Finance, Healthcare Administration, Business, Analytics, or a related field required
- Master’s degree preferred
Experience
- 5+ years of healthcare revenue cycle experience, with demonstrated focus on payer reimbursement, denials, or managed care analytics
- Proven experience analyzing payer contracts, reimbursement methodologies, and payer policies
- Hands-on experience with denial data, underpayment identification, and revenue integrity initiatives
- Experience working cross-functionally with Revenue Cycle, Managed Care, Finance, and Operations teams
Required Skills & Competencies
Technical & Analytical Skills
- Strong understanding of healthcare reimbursement (commercial, Medicare, Medicaid)
- Expertise in interpreting payer contracts and translating contract language into analytical models
- Advanced analytical skills with large, complex datasets
- Proficiency in Excel; experience with SQL, Tableau, Power BI, or similar analytics tools preferred
- Ability to independently validate payments against contract terms and payer rules
Business & Communication Skills
- Ability to explain complex payer and revenue concepts clearly to both technical and non-technical audiences
- Strong written and verbal communication skills, including executive presentation capability
- High level of attention to detail with a strategic, outcome-oriented mindset
Professional Attributes
- Self-directed with strong prioritization and problem-solving skills
- Comfortable working in an ambiguous, fast-paced healthcare environment
- Demonstrated curiosity and commitment to continuous improvement in revenue performance
Preferred Qualifications
- Experience with revenue integrity, payment variance analysis, or contract modeling tools
- Knowledge of healthcare billing systems (Epic, Cerner, or similar)
- Experience supporting managed care negotiations or payer dispute resolution
- Certification in healthcare finance, analytics, or revenue cycle (HFMA, CHFP, etc.)
Our Commitment to You:
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:
Compensation
- Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
- Premium pay such as shift, on call, and more based on a teammate's job
- Incentive pay for select positions
- Opportunity for annual increases based on performance
Benefits and more
- Paid Time Off programs
- Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
- Flexible Spending Accounts for eligible health care and dependent care expenses
- Family benefits such as adoption assistance and paid parental leave
- Defined contribution retirement plans with employer match and other financial wellness programs
- Educational Assistance Program
About Advocate Health
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.
