Financial Operations Analyst Senior

8am-5pm, M-F, Remote

Variability in hours based on various project requirements

Pay Range

• 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.

• 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.

• 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.

• 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.

• 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.

• 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

• 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

• 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

• 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

• 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

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.