[Hiring] Network Reimbursement Analyst @St. Luke's Health System

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Network Reimbursement Analyst is responsible for developing, maintaining, and updating SLHP’s fee schedule, pricing updates, and reimbursement policy execution. The role evaluates Medicare and industry changes, translates coding and regulatory updates into pricing recommendations, and models the financial impact of reimbursement decisions on provider performance and network affordability. • Support the development, updates, and maintenance of SLHP professional and facility fee schedules by applying established pricing methodologies (percent-of-Medicare, custom rates, case rates, blended models) and ensuring accuracy across annual update cycles. • Monitor and interpret Medicare updates, CPT/HCPCS changes, RVU shifts, APC/DRG refinements, modifier rules, NCCI edits, and payer policy changes; prepare analytical summaries and recommended pricing adjustments. • Build and maintain models using claims, clinical, and operational data to evaluate the financial and operational impact of reimbursement changes on provider revenue, medical spend (PMPM), site-of-service patterns, and value-based care programs. • Prepare scenario models, forecasts, dashboards, and ad-hoc analyses to support payer contracting, strategy development, and network performance monitoring. • Perform post-claims audits, confirm alignment with fee schedules and reimbursement policies, and collaborate with Data & Analytics teams to validate datasets and ensure analytical reliability. • Collaborate with contracting, provider relations, finance, and analytics partners to provide reimbursement insights and communicate findings clearly to a variety of stakeholders. • Document pricing logic, analytic assumptions, data sources, and methodologies; contribute to analytical best practices and team knowledge-sharing. Qualifications • Bachelor's degree or experience in lieu of degree • 4 years' relevant experience • Remote work supported from Idaho, Oregon, Utah, and Arizona ONLY Benefits • Robust benefits package to support teams both professionally and personally • Competitive salary and retirement plans • Financial and physical wellness options, such as on-site massages and counseling via Employee Assistance Program • Access to the Personify Health Wellness tool • Formal training and career development offerings Apply tot his job Apply tot his job