Expert-level knowledge of healthcare reimbursement methodologies (DRG/IPPS, OPPS, capitation, percent-of-Medicare, bundled payments, risk arrangements). * Advanced financial modeling and analytical ...
Expert-level knowledge of healthcare reimbursement methodologies (DRG/IPPS, OPPS, capitation, percent-of-Medicare, bundled payments, risk arrangements). * Advanced financial modeling and analytical ...
SHP Provider Contracting Consult-Senior
Corvallis, OR · On-site
$42.11 - $63.16/hr
Expert-level knowledge of healthcare reimbursement methodologies (DRG/IPPS, OPPS, capitation, percent-of-Medicare, bundled payments, risk arrangements). * Advanced financial modeling and analytical ...
SHP Provider Contracting Consult-Senior
Corvallis, OR · On-site
$42.11 - $63.16/hr
Expert-level knowledge of healthcare reimbursement methodologies (DRG/IPPS, OPPS, capitation, percent-of-Medicare, bundled payments, risk arrangements). * Advanced financial modeling and analytical ...
OR · On-site
Analyze high-risk accounts to identify fraudulent merchants, card testing, account takeovers, and ... Experience in payments, e-commerce, social media, or fintech, mitigating digital or card-not ...
$130K - $140K/yr
... risk assessment, claims analysis, reserve evaluations, outside counsel management, and ... Radiology Partners will never request payment, banking or other financial information in exchange ...
$130K - $140K/yr
... risk assessment, claims analysis, reserve evaluations, outside counsel management, and ... Radiology Partners will never request payment, banking or other financial information in exchange ...
Payments Strategy Manager
Portland, OR · On-site
Partner with finance and risk to inform credit strategies. * Improve authorization rates and ... Analyze performance and optimize product strategy. * Calculate impact and ROI for growth and ...
Payments Strategy Manager
Portland, OR · On-site
Partner with finance and risk to inform credit strategies. * Improve authorization rates and ... Analyze performance and optimize product strategy. * Calculate impact and ROI for growth and ...
Leverage analytics to identify emerging industry risk trends and proactively adjust exposure ... This role is critical to building a resilient, scalable payments platform that accelerates merchant ...
Leverage analytics to identify emerging industry risk trends and proactively adjust exposure ... This role is critical to building a resilient, scalable payments platform that accelerates merchant ...
Payments Strategy Manager
Portland, OR · On-site
... finance and risk to inform credit strategies. • Improve authorization rates and network ... Analyze performance and optimize product strategy. • Calculate impact and ROI for growth and ...
Payments Strategy Manager
Portland, OR · On-site
... finance and risk to inform credit strategies. • Improve authorization rates and network ... Analyze performance and optimize product strategy. • Calculate impact and ROI for growth and ...
Fraud Patterns Analyst
OR · Remote
... Stripe to accept payments, grow their revenue, and accelerate new business opportunities. Our ... About the team The Risk Operations team is looking for an experienced fraud analyst to join an ...
Fraud Patterns Analyst
OR · Remote
... Stripe to accept payments, grow their revenue, and accelerate new business opportunities. Our ... About the team The Risk Operations team is looking for an experienced fraud analyst to join an ...
Corporate Credit Analyst
Clackamas, OR · On-site
$28/hr
Corporate Credit Analyst Pay: $28.00/hour Schedule: Monday - Friday Hours: 7:00am - 4:00pm (1-Hour ... Monitor existing accounts for risk exposure, delinquencies, and payment trends * Partner with ...
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Corporate Credit Analyst
Clackamas, OR · On-site
$28/hr
Corporate Credit Analyst Pay: $28.00/hour Schedule: Monday - Friday Hours: 7:00am - 4:00pm (1-Hour ... Monitor existing accounts for risk exposure, delinquencies, and payment trends * Partner with ...
... risk management, or trust & safety, specifically within fintech, banking, or the payments industry ... Analytical Skills: Proficiency in data analysis using SQL and Python. Ability to connect the dots ...
$126K - $166K/yr
Ensure products are built with a strong understanding of payments operations, risk, compliance, and ... Use product analytics, customer feedback, and operational data to inform prioritization and ...
$130K - $175K/yr
... payments. At Mesh, we're connecting hundreds of exchanges, wallets, and financial platforms into a ... Conduct vendor and third-party risk assessments as we expand our global network of partners.
OR · On-site
... risk, bad debt, payments, accounts receivable). * Background in data modeling and building scalable analytics
OR · On-site
... risk, bad debt, payments, accounts receivable). * Background in data modeling and building scalable analytics
$126K - $166K/yr
Product Manager - Payments Our client is seeking a Product Manager with a B2B SaaS background to ... risk, and keep projects on track. Analytical ability to predict, measure, and communicate the ...
$126K - $166K/yr
Product Manager - Payments Our client is seeking a Product Manager with a B2B SaaS background to ... risk, and keep projects on track. Analytical ability to predict, measure, and communicate the ...
... Analyst). In this role, you'll be the bridge between our internal sales teams and external ... Assess credit risk and recommend solutions to Underwriting team. * Negotiate payment plans with ...
... Analyst). In this role, you'll be the bridge between our internal sales teams and external ... Assess credit risk and recommend solutions to Underwriting team. * Negotiate payment plans with ...
Credit Analyst II - Portland
Portland, OR · On-site
... Analyst). In this role, you'll be the bridge between our internal sales teams and external ... Assess credit risk and recommend solutions to Underwriting team. * Negotiate payment plans with ...
Credit Analyst II - Portland
Portland, OR · On-site
... Analyst). In this role, you'll be the bridge between our internal sales teams and external ... Assess credit risk and recommend solutions to Underwriting team. * Negotiate payment plans with ...
VP, Risk (Fraud Strategy & Analytics)
$144K - $184K/yr
Own fraud strategy for identity fraud and for existing account fraud (transaction fraud, payment ... in fraud risk modeling and be able to guide the data scientists and analysts towards optimal ...
VP, Risk (Fraud Strategy & Analytics)
$144K - $184K/yr
Own fraud strategy for identity fraud and for existing account fraud (transaction fraud, payment ... in fraud risk modeling and be able to guide the data scientists and analysts towards optimal ...
VP, Risk (Fraud Strategy & Analytics)
Beaverton, OR · On-site
$144K - $184K/yr
As our Vice President, Risk (Fraud Strategy & Analytics) , you'll help drive Concora Credit ... Own fraud strategy for identity fraud and for existing account fraud (transaction fraud, payment ...
VP, Risk (Fraud Strategy & Analytics)
Beaverton, OR · On-site
$144K - $184K/yr
As our Vice President, Risk (Fraud Strategy & Analytics) , you'll help drive Concora Credit ... Own fraud strategy for identity fraud and for existing account fraud (transaction fraud, payment ...
VP, Risk (Fraud Strategy & Analytics)
$144K - $184K/yr
Own fraud strategy for identity fraud and for existing account fraud (transaction fraud, payment ... in fraud risk modeling and be able to guide the data scientists and analysts towards optimal ...
VP, Risk (Fraud Strategy & Analytics)
$144K - $184K/yr
Own fraud strategy for identity fraud and for existing account fraud (transaction fraud, payment ... in fraud risk modeling and be able to guide the data scientists and analysts towards optimal ...
VP, Risk (Fraud Strategy & Analytics)
Beaverton, OR · On-site
$144K - $184K/yr
Own fraud strategy for identity fraud and for existing account fraud (transaction fraud, payment ... in fraud risk modeling and be able to guide the data scientists and analysts towards optimal ...
VP, Risk (Fraud Strategy & Analytics)
Beaverton, OR · On-site
$144K - $184K/yr
Own fraud strategy for identity fraud and for existing account fraud (transaction fraud, payment ... in fraud risk modeling and be able to guide the data scientists and analysts towards optimal ...
Payments Risk Analyst information
What are the key skills and qualifications needed to thrive as a Payments Risk Analyst, and why are they important?
What are some common challenges faced by Payments Risk Analysts in monitoring and mitigating transaction fraud?
What are Payments Risk Analysts?
Other
Posted 8 days ago
Samaritan Health Services rating
7.5
Based on 65 frontline employees who took The Breakroom Quiz
232nd of 884 rated healthcare providers
Job description
- This is a remote position in which we are able to employ in the following states: Alabama, Alaska, Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin
- JOB SUMMARY/PURPOSE
- Responsible for leading complex, high-value provider contracting initiatives across Medicaid, Medicare Advantage, and Commercial lines of business. Participates in the development of and executes multi-year contracting strategies for hospitals, health systems, large physician organizations, and other strategic providers. Serves as a subject matter expert in reimbursement methodologies, value-based payment design, and regulatory compliance. Leads high-stakes negotiations, performs advanced financial modeling, advises executive leadership on network strategy, and mentors contracting staff. Exercises broad discretion within delegated authority and significantly influences organizational cost-of-care, network adequacy, and quality performance outcomes.
- DEPARTMENT DESCRIPTION
Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage and Commercial Large Group plans. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.
- EXPERIENCE/EDUCATION/QUALIFICATIONS
- Bachelor’s degree in Business Administration, Healthcare Administration, Finance, or a related field, or equivalent related experience required.
- Four (4) years of progressive provider contracting experience in a managed care environment required.
- Experience negotiating complex hospital, health system, and risk-based agreements required.
- Experience across Medicaid, Medicare Advantage, and Commercial product lines required.
- Extensive experience designing and managing value-based payment and alternative payment models required.
- KNOWLEDGE/SKILLS/ABILITIES
- Deep understanding of federal and state regulatory requirements. Expert-level knowledge of healthcare reimbursement methodologies (DRG/IPPS, OPPS, capitation, percent-of-Medicare, bundled payments, risk arrangements).
- Advanced financial modeling and analytical skills (expert-level Excel proficiency required).
- Ability to manage multiple high-priority initiatives simultaneously. Exceptional negotiation, influence, and conflict resolution skills.
- Strong executive presence and ability to communicate complex financial concepts to senior leadership.
- Strategic thinker with strong business and market acumen.
- Proven leadership and mentoring capability.
- PHYSICAL DEMANDS
Rarely
(1 - 10% of the time)Occasionally
(11 - 33% of the time)Frequently
(34 - 66% of the time)Continually
(67 – 100% of the time)CLIMB - STAIRS
LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs
LIFT (Knee to chest: 24"-54") 0 – 20 Lbs
LIFT (Waist to Eye: up to 54") 0 - 20 Lbs
CARRY 1-handed, 0 - 20 pounds
BEND FORWARD at waist
KNEEL (on knees)
STAND
WALK – LEVEL SURFACE
ROTATE TRUNK Standing
REACH - Upward
PUSH (0 - 20 pounds force)
PULL (0 - 20 pounds force)
SIT
CARRY 2-handed, 0 - 20 pounds
ROTATE TRUNK Sitting
REACH - Forward
MANUAL DEXTERITY Hands/wrists
FINGER DEXTERITY
PINCH Fingers
GRASP Hand/Fist
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