Network Pricing Consultant - Remote in CST/EST preferred

Overview

This role supports and validates Provider Network contracting and unit cost management activities through financial modeling, analysis, and reporting. The position focuses on accurately and effectively pricing the provider network across East Region markets, including Kentucky, Indiana, and Ohio.

You will work remotely from anywhere within the U.S.

Responsibilities

• Support network pricing strategies and tactics in collaboration with local network field leaders and network managers
• Analyze the financial impact of provider contracts
• Evaluate the financial impact of corporate initiatives and external regulations
• Review payment appendices and develop options for various contracting approaches and methodologies
• Conduct financial and network pricing modeling, analysis, and reporting
• Perform unit cost and contract valuation analysis to support network contracting and unit cost management strategies
• Manage unit cost budgets, targets, and performance reporting
• Communicate financial impact findings and insights to stakeholder groups
• 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
• Lead large and complex analytical projects aligned to key business objectives
• Participate in mentorship and detailed peer review activities

Required Qualifications

• 4+ years of analytical experience
• 3+ years of experience with provider payment methodologies and healthcare products
• Experience presenting to internal or external stakeholders
• Demonstrated financial impact analysis and data manipulation skills
• Demonstrated advanced proficiency in Microsoft Excel
• Proven ability to interpret financial modeling results and develop forecasts
• Proven ability to manage multiple projects simultaneously
• Proven ability to research and solve problems independently

Preferred Qualifications

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

Compensation & Benefits

• Salary range: $72,800 - $130,000 annually (based on full-time employment)
• Pay is based on several factors including local labor markets, education, work experience, certifications, etc.
• Benefits may include a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (eligibility requirements apply).

Location

Remote work available from anywhere within the U.S.

Additional Information

• All employees working remotely will be required to adhere to the company’s Telecommuter Policy.
• Application deadline: Posted for a minimum of 2 business days or until a sufficient candidate pool has been collected; the posting may come down early due to volume of applicants.
• Drug-free workplace: Candidates are required to pass a drug test before beginning employment.