Senior Long-Term Care - Rate Setting Analyst

Overview

This role is for a Senior Long-Term Care – Rate Setting Analyst supporting rate-setting and reimbursement strategies for a large, complex Medicaid long-term care program. You will develop and maintain rate-setting methodologies, interpret policy impacts—especially within Wisconsin Medicaid—and analyze how rate decisions affect Managed Care Organizations (MCOs) and the broader long-term care ecosystem.

Responsibilities

• Lead the development, enhancement, and documentation of rate-setting models for long-term care programs
• Use advanced analytical techniques and large datasets to evaluate costs, trends, and reimbursement outcomes
• Assess how rate changes, policy updates, and cost drivers affect Managed Care Organizations (MCOs)
• Translate business needs into clear data, system, and policy requirements
• Research reimbursement methodologies, program operations, and the long-term care ecosystem to recommend improvements
• Support development and implementation of capitated rate-setting methodologies for contracted MCOs
• Validate the accuracy and sufficiency of rates produced by established models
• Monitor State and Federal policy changes (with emphasis on Wisconsin Medicaid) and assess operational and financial impact
• Partner with internal teams, business leaders, and external stakeholders to promote transparency and alignment in rate-setting practices
• Prepare written analyses, presentations, and recommendations for leadership, clients, and technical teams

Requirements

• 6+ years of experience in business analysis, financial modeling, health policy analysis, Medicaid policy analysis, public administration, or public sector program evaluation
• Strong data expertise, including understanding how rate-setting decisions impact Managed Care Organizations (MCOs)
• Experience interpreting public policy, preferably within healthcare and/or Wisconsin Medicaid
• Understanding of the Long-Term Care (LTC) ecosystem, including program structures and reimbursement models
• Advanced skills in Excel and/or analytical tools such as R, SAS, STATA, or SPSS
• Strong statistical analysis, quantitative modeling, and data interpretation skills, with the ability to translate complex findings into actionable recommendations
• Strong communication skills to translate complex analytical work into clear, actionable insights
• Ability to work independently, manage timelines, and support multiple projects at once
• Bachelor’s degree in Public Administration, Public Policy, Economics, Statistical Analysis, Healthcare Administration, Finance, or a related field; master’s degree preferred

Preferred Qualifications

• Experience evaluating government, business, or healthcare policies that affect internal and external partners
• Experience working with Medicaid programs, rate-setting methodologies, or capitated payment models
• Experience analyzing large datasets and developing quantitative or statistical models
• Ability to write and present comprehensive reports, analyses, and policy summaries
• Strong problem-solving skills and a track record of recommending improvements to business or technical processes
• Experience with SQL or data warehouse tools
• Education or training in public policy, economics, statistics, or a related field
• Familiarity with State/Federal regulations influencing long-term care and Medicaid operations
• Professional experience working within a state Medicaid agency, state policy office, healthcare policy organization, or government-funded healthcare program
• Experience working for or directly supporting Managed Care Organizations (MCOs), including an understanding of managed care financing and oversight
• Knowledge of Medicaid policy, healthcare reimbursement methodologies, actuarial concepts, and capitation rate development
• Experience evaluating the financial and operational impacts of capitation rates, rate adjustments, and value-based payment arrangements

Compensation & Benefits

• Pay range: $69,400.00 - $99,200.00 per year
• Base pay may vary based on geographic region, internal equity, job-related knowledge, skills, and experience, among other factors
• Full-time salaried candidates are eligible for:
  • Generous, flexible vacation policy
  • 401(k) employer match
  • Comprehensive health benefits
  • Educational assistance

Location

• Fully remote options from Contiguous US locations only

Additional Information

• Video cameras must be used during all interviews and during the initial week of orientation
• A photo will be taken during screening for verification in all steps of the recruitment process
• Deadline to submit applications: November 12, 2026
• Applicants should join all screenings, interviews, and meetings from a quiet location with a stable internet connection
• Video is required for screenings and interviews; please test your camera and microphone in advance
• Do not use AI tools, virtual backgrounds/filters, or visual enhancements during the interview

Equal Opportunity

All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.