Manager, Strategic Pricing and Analytics

This is a fully remote position, open to applicants in Tennessee.

📋 Description

• Lead the analytics for anesthesia reimbursement, including forecasting, analysis of payer trends, identification of variances, and strategic recommendations for pricing.

• Provide advanced analytics for Out-Of-Network (OON) and the No Surprises Act (NSA), support the Independent Dispute Resolution (IDR) process, and develop dashboards and financial models that guide leadership and enhance pricing and revenue optimization.

• Assist in the development and maintenance of the Ambulatory Surgical Center (ASC) chargemaster by conducting thorough analyses, updating CPT mappings, establishing fee parameters, and preparing recommended charge models based on contract terms, volume data, and payer requirements.

• Manage the coordination of approvals and compliance workflows by tracking centers, reviewing operating agreements and payer notification language, preparing analyses and proposed chargemasters, and overseeing the approval process.

• Create and distribute finalized chargemasters and documentation by generating distribution files, maintaining tracking logs, ensuring compliance with effective dates and notification timelines, and facilitating payer notifications and operational implementation.

• Supervise the execution of ad hoc reimbursement analyses and other custom analytics as requested by leadership to support informed strategic decision-making.

⛳️ Requirements

• A Bachelor’s degree is required, ideally in Finance, Accounting, Healthcare Administration, or a related discipline.

• 5–7 years of progressive experience in healthcare analytics, pricing, or reimbursement analysis.

• In-depth knowledge of the healthcare industry, managed care contracts, reimbursement methodologies, and pricing strategies.

• Proven track record of strong critical thinking and problem-solving skills.

• Proficiency in Microsoft Office applications, with advanced Excel skills necessary.

• Basic working knowledge of SQL is required.

• Ability to construct and audit complex Excel-based financial models, analyze data, and convert analyses into targeted actions that drive results.

• Expertise in managing complex and large datasets.

• Demonstrated capability to design, develop, and implement both routine and custom reporting.

• Proven ability to effectively communicate with C-suite and executive leadership.

🏝️ Benefits

• Paid Time Off

• Medical

• Dental

• Vision

• Life

• Disability

• Healthcare Flexible Spending Account (FSA)

• Dependent Care FSA

• Limited Healthcare FSA

• FSAs for Transportation and Parking & Health Savings Accounts (HSAs)

• Matching 401(K) Plan

• 9 observed holidays

• Paid family leave