Sr. Contract Pricing Analyst

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Job description

We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.

Uses industry experience and knowledge to develop pricing models for proposals within Prospect Medical System. Serve as the SME for contract pricing department. Provides consultation, analysis, and guidance to create pricing solutions to maximize profit. Supports and validates Provider Network (physicians, hospitals, pharmacies, ancillary services, etc.) contracting activities through financial and network pricing modeling, analysis, and reporting. Conducts contract valuation analysis in support of Contracting negotiations and cost management strategies.

Job Responsibilities/Duties

• With limited guidance, develops pricing models for proposals within Prospect Medical System for multiple types of providers (physician, hospital, pharmacy, ancillary services, etc.).
• Analyze data from multiple sources and integrate into interactive pricing models including but not limited to clinical, quality, financial, and claims data.
• Provides consultation, analysis, and guidance to create pricing solutions to maximize profit.
• Develops pricing strategies for newly created business growth as well as existing business with limited guidance.
• Proactively identify issues and inconsistencies as well as potential risk and pulls ideas, issues, observations, and recommendations into clear and concise presentation to internal clients.
• Works with contract leads to identify unit cost savings opportunities and achieve unit cost targets and contracting initiatives.
• Assists in the design, development, and implementation of advanced ad hoc reports.
• Assists in identifying and documenting reporting requirements, extracting and manipulating data from databases, and performing acceptance and QA testing as applicable.
• Collaborates with management team in analysis, requiring expertise in procedure codes and claims, identifying problem areas.
• Develops analysis to identify cause of problem and facilitate a resolution.

Qualifications

Minimum Education: Bachelor's degree or equivalent education and experience in business, finance, economics, mathematics, or related field required.

Minimum Experience: Five or more (5+) years of experience in financial analysis, claims pricing, network management, or economics in the health care environment required. Five or more ( 5+) years of experience in provider payment methodologies and healthcare products required. five or more (5+) years of experience presenting findings to management required.

Req. Certification/Licensure: None.

Employee Value Proposition

Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals you will receive:

• Company 401K
• Medical, dental, vision insurance
• Paid time-off
• Life insurance

Prospect Medical Systems has a zero-tolerance policy regarding the use of drugs and alcohol. Our Company is committed to maintaining a productive, drug free workplace that keeps employees and patients safe from harm. For this reason, we require applicants to pass a screening for drug use as a condition of employment. This includes: alcohol, marijuana, cocaine, opiates and methamphetamines.