Financial Operations Analyst Senior

Role Description

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.

Qualifications

• Bachelor’s degree in Finance, Healthcare Administration, Business, Analytics, or a related field required
• Master’s degree preferred
• 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.)

Benefits

• 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