Knowledge of value-based payment models and reimbursement methodologies, including Accountable Care Organizations (ACOs), bundled payments, shared savings arrangements, pay-for-performance programs, capitation, and other alternative payment models. The successful candidate will possess deep knowledge of the U.S. healthcare industry and fee-for-service claims adjudication processes, including claims intake, benefit determination, pricing, reimbursement methodologies, edits, payment calculation, and claims lifecycle management.