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Senior Financial Analyst, Health Plan Pricing Specialist
2 months ago
We are seeking a highly skilled Senior Financial Analyst to join our team at Quest Diagnostics. As a Senior Financial Analyst, you will play a critical role in supporting the financial and operational evaluation of prospective Health Plan contracts.
Key Responsibilities- Perform comprehensive financial analyses to support the development of third-party contracts, including fee schedule compilation, revenue projections, synergy analyses, and 'what-if' scenarios.
- Calculate specific CAP PMPM rates and develop CPT-based fee schedules for key regional and national contracts.
- Develop utilization and membership corridors and integrate them into contracts where applicable to protect the Company from downstream risk with capitated arrangements.
- Support the development of standard premium priced tests, capitation carve-outs, and overall pricing guidelines.
- Collaborate with the Clinical Franchise department to ensure that pricing guidelines for high-value and new test campaigns are considered in prospective contracts.
- Serve as a content expert to regional leadership regarding third-party contracts and pricing strategies.
- Interface directly with regional leadership regarding the price, volume, and cost implications associated with new and existing third-party contracts.
- Develop methods to streamline the pricing review and authorization process for third-party contracts.
- Perform specific test campaign analyses to determine the prospective revenue and volume impact for key test initiatives.
- Partner with the Billing function to review, disseminate, and recommend enhancements to third-party data used to build financial models.
- Support the annual budget process by providing details and insights on known and potential contract changes in the coming year.
- Bachelor's degree
- A minimum of three years relevant financial analysis experience
- Strong understanding of the healthcare industry and health plans specifically (product types, trends, etc.)
- Strong financial and analytical skills
- Innovative thinker comfortable with ambiguity to complete tasks
- Ability to work effectively cross-functionally in a matrix environment and build/maintain relationships
- Excellent verbal and written communication skills
- Ability to work effectively both independently and within a team
- Strong PC skills (Excel, Access, PowerPoint, Word)
