The Pricing Analyst plays a key role in shaping financial strategy by delivering data-driven insights that guide pricing decisions across a $5 billion healthcare enterprise. Working closely with business development and financial leadership, this position analyzes complex internal and external data to support contract negotiations, pricing frameworks, and value-based care initiatives.
Key Responsibilities
- Design and implement pricing strategies for healthcare services across diverse markets and payor types
- Analyze cost structures, utilization trends, and reimbursement models to assess financial risk and opportunity
- Support contract development and renewal processes with detailed financial modeling and forecasting
- Investigate total cost of care across patient populations to inform risk-adjusted pricing approaches
- Model the financial impact of utilization changes under risk-sharing arrangements
- Lead episode-based pricing initiatives aligned with CMS and commercial payor requirements
- Integrate data from internal systems and external sources to generate actionable insights
Qualifications
- Bachelor’s degree in Accounting, Finance, Economics, Healthcare Administration, or a related discipline
- At least five years of experience in healthcare financial analysis
- Proficiency with MS Office, particularly Excel and Access, for managing complex datasets
- Understanding of medical coding systems including CPT4, ICD10CM, and DRGs
- Knowledge of Medicare reimbursement structures and managed care contracting
- Ability to translate analytical findings into clear, strategic recommendations
- Strong communication skills with experience presenting to senior leadership
- Familiarity with accounting and economic principles as applied to healthcare delivery
Preferred Background
- Graduate-level education in a relevant field
- Experience with alternative payment models and value-based care programs
- Background in health insurance or payer operations
- Technical skills in SQL, SAS/Webi, or similar database tools
Work Environment
This is a fully remote role open to candidates residing in North Carolina, South Carolina, Georgia, or Virginia. The analyst will collaborate across executive and clinical teams, contributing to data-informed strategies that shape the future of care delivery and payment innovation.
Impact and Growth
The role offers direct involvement in strategic pricing decisions and exposure to emerging models such as episodic payment contracts and risk-based reimbursement frameworks. Analysts will engage with leadership to advance transformational initiatives grounded in analytics and financial rigor.
