Senior Healthcare Pricing Subject Matter Expert
J
JobgetherHealthcare Finance
Based in United StatesFull-TimeSenior
Salary100,000 - 150,000 USD per year
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Job Details
- Experience
- At least 8 years
- Required Skills
- Data AnalysisMicrosoft Excel
Requirements
- Bachelor’s degree in Finance, Accounting, Economics, Mathematics, Actuarial Science, Business, Statistics, Healthcare Analytics, or a related analytical discipline.
- At least 8 years of progressively responsible experience in pricing, financial analysis, proposal evaluation, or healthcare economics.
- At least 6 years of experience analyzing managed healthcare pricing including provider reimbursement, network discounts, claims pricing, and risk-sharing.
- At least 6 years of experience evaluating complex proposals and developing defensible financial conclusions.
- Advanced Excel and financial modeling capabilities, with strong attention to formulas, reconciliations, and data integrity.
- Excellent technical writing and documentation skills to produce clear and traceable analytical reports.
- Experience with federal proposal evaluations, negotiated acquisitions, and price analysis is highly desirable.
- Knowledge of FAR Part 15 is preferred.
- Experience with large-scale government healthcare programs (e.g., Medicare, Medicaid, TRICARE) is preferred.
- Familiarity with healthcare claims, encounter, eligibility, provider, utilization, and reimbursement data is advantageous.
- Experience with Power Query, Power BI, SQL, Python, or R is a plus.
- Relevant certifications such as CPCM, CFCM, CCEA, CPA, CMA, or CFA are desirable.
Responsibilities
- Lead financial and price analysis of complex managed healthcare proposals associated with a federal procurement valued at nearly $1 trillion.
- Review solicitation requirements, evaluation criteria, contract terms, and amendments to assess proposal compliance.
- Crosswalk offeror pricing submissions against required contract structures, line items, and supporting documentation.
- Analyze healthcare pricing components including provider reimbursement rates, unit prices, administrative fees, and utilization assumptions.
- Validate pricing workbooks by reviewing formulas, calculations, reconciliations, and data integrity.
- Normalize and compare competing proposals using benchmarks, historical results, and government data.
- Identify deficiencies, outliers, unsupported assumptions, and potential financial risks.
- Develop clarification questions and evidence-based negotiation recommendations.
- Prepare detailed Price Analysis Reports, executive briefings, and traceable source-selection workpapers.
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