Senior Pricing Analyst

Overview

This role is 100% remote and supports evaluation of complex managed healthcare pricing proposals for a major federal procurement valued at nearly $1 trillion. The Senior Healthcare Pricing Subject Matter Expert (SME) will analyze pricing and reimbursement approaches, identify financial risks and inconsistencies, and develop price analysis and negotiation recommendations.

Clearance

• Must be currently authorized to work in the United States on a full-time basis.
• Ability to obtain a Public Trust Security Clearance.

Responsibilities

• Lead financial and price analysis of complex managed healthcare proposals valued at nearly $1 trillion.
• Review solicitation requirements, evaluation criteria, contract terms, amendments, and Government guidance to assess proposal compliance.
• Crosswalk Offeror pricing submissions against required structures, contract line items, periods, regions, benefit categories, and supporting data.
• Analyze rates, unit prices, administrative fees, discounts, reimbursement methodologies, escalation factors, trend assumptions, staffing costs, and other key cost drivers.
• Validate pricing workbooks by reviewing formulas, calculations, reconciliations, cross-references, and supporting documentation.
• Normalize and compare competing proposals using independent estimates, historical results, market benchmarks, Government data, and other Offeror submissions.
• Identify deficiencies, outliers, unsupported assumptions, inconsistencies, ambiguities, unbalanced pricing, and potential cost or performance risks.
• Develop clarification questions and evidence-based negotiation recommendations, including proposed positions and potential financial impacts.
• Prepare Price Analysis Reports, executive briefings, comparison tables, decision-support materials, and traceable source-selection workpapers; incorporate actuarial findings as appropriate.
• Update analyses through clarifications, proposal revisions, negotiations, and Government direction while maintaining procurement-sensitive information and meeting accelerated timelines.

Requirements

• Bachelor's degree in Finance, Accounting, Economics, Mathematics, Actuarial Science, Business, Statistics, Healthcare Analytics, or a related field.
• 8+ years of experience in progressively responsible pricing, financial analysis, proposal evaluation, healthcare economics, or related analytical work.
• 6+ years of experience analyzing managed healthcare pricing, including provider reimbursement, network discounts, claims pricing, administrative fees, utilization, trend assumptions, or risk-sharing arrangements.
• 6+ years of experience analyzing complex proposals and developing defensible financial conclusions, with advanced Excel, financial modeling, reconciliation, and technical-writing skills.

Preferred Qualifications

• Experience supporting federal proposal evaluations, negotiated acquisitions, and price analysis.
• Knowledge of FAR Part 15, including price analysis, proposal evaluation, clarifications, discussions, final proposal revisions, and negotiation documentation.
• Experience preparing price analysis reports, negotiation memoranda, evaluation findings, or similar acquisition documentation.
• Experience analyzing large-scale government healthcare programs, health-plan procurements, managed-care contracts, or provider networks, including Medicare, Medicaid, TRICARE, VA Community Care, or FEHB.
• Experience working with healthcare claims, encounter, eligibility, provider, utilization, and reimbursement data and analytical tools such as Power Query, Power BI, SQL, Python, or R.
• Relevant professional certification such as CPCM, CFCM, CCEA, CPA, CMA, CFA, or comparable credential.