Network Pricing Consultant - Remote PST/MST/CST

Primary Responsibilities

• Support network pricing strategies and tactics in collaboration with local network field leaders and network managers
• Analyze financial impact of provider contracts
• Evaluate financial impact of corporate initiatives and external regulations
• Review payment appendices and develop options for various contracting approaches and methodologies
• Communicate financial impact findings and insights to stakeholder groups
• Conduct financial and network pricing modeling, analysis, and reporting
• Provide mentorship and engage in detailed peer review activities
• Perform unit cost and contract valuation analysis to support network contracting and unit cost management strategies
• Lead large and complex analytical projects to support key business objectives
• Influence pricing strategies and rate development by identifying opportunities or safeguarding favorable structures
• Collaborate with Network Management to strategize rates or contract methodologies
• Review competitive analysis to determine appropriate provider pricing

Required Qualifications

• Undergraduate degree in Math, Statistics, Finance, Economics, or related field
• 4+ years of analytical experience
• 3+ years of experience with provider payment methodologies and healthcare products
• Experience presenting to internal or external stakeholders
• Financial impact analysis and data manipulation skills
• Advanced proficiency in Microsoft Excel
• Demonstrated ability to interpret financial modeling results and develop forecasts
• Demonstrated ability to manage multiple projects simultaneously
• Demonstrated ability to research and solve problems independently

Preferred Qualifications

• Experience with advanced statistical functions for financial modeling
• Experience with various payment methodology types
• Knowledge of commercial, Medicare, and Medicaid PPO/HMO revenue and expense patterns
• Solid interpersonal, collaboration, negotiation, and communication abilities