Contract Pricing Analyst II

2 weeks ago

Orange, United States Prospect Medical Holdings Full time
Job Description

Contract Pricing Analyst II - Full Time, Days (Remote)
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.

The Contract Pricing Analyst II uses industry experience and knowledge to develop pricing models for proposals within Prospect Medical System. 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.
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, benefit eligible positions will receive:
  • Company 401K
  • Medical, dental, vision insurance
  • Paid time-off
  • Life insurance
Responsibilities

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. Analyzes relationships with contracted entities with Network Management and Contracting departments to anticipate obstacles and think ahead on next steps.
  • 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.
  • Performs and leads special projects as assigned.


Qualifications

Qualifications

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

Minimum Experience: Two plus (2+) years of experience in financial analysis, claims pricing, network management, or economics in the health care environment required. Two plus (2+) years of experience in provider payment methodologies and healthcare products required. 2+ years of experience presenting findings to management required. Must be a self-starter, fast learner, strong individual contributor, and team player.

Req. Certification/Licensure: None.

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