Contract Pricing Specialist

2 days ago


Orange, California, United States Prospect Medical Holdings Full time
Job Title: Contract Pricing Analyst I

At Prospect Medical Holdings, we are seeking a highly skilled Contract Pricing Analyst I to join our team. As a key member of our pricing team, you will play a critical role in developing pricing models for proposals within our organization.

Key Responsibilities:
  • Develop 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.
  • Provide consultation, analysis, and guidance to create pricing solutions to maximize profit.
  • Develop pricing strategies for newly created business growth as well as existing business.
  • Proactively identify issues and inconsistencies as well as potential risk and pull ideas, issues, observations, and recommendations into clear and concise presentation to internal clients.
  • Work with contract leads to identify unit cost savings opportunities and achieve unit cost targets and contracting initiatives.
  • Assist in the design, development, and implementation of advanced ad hoc reports.
  • Collaborate with management team in analysis, requiring expertise in procedure codes and claims, identifying problem areas.
Requirements:
  • 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.
  • Bachelor's degree or equivalent education and experience in business, finance, economics, mathematics, or related field required.


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