Manager, Strategic Pricing and Analytics – Health Plan Relations

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

📋 Description

• Lead the analytics for anesthesia reimbursement, encompassing forecasting, analysis of payer trends, identification of variances, and strategic pricing recommendations for commercial, government, and out-of-network (OON) payment scenarios.

• Provide advanced analytics for OON and No Surprises Act (NSA), support the Independent Dispute Resolution (IDR) process, and develop dashboards and financial models that inform leadership while optimizing pricing and revenue.

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

• Facilitate the coordination of approvals and compliance workflows by monitoring centers, reviewing operating agreements and payer notification language, preparing analyses and proposed chargemasters, and managing the approval processes.

• Prepare and distribute finalized chargemasters and related documentation by creating distribution files, maintaining tracking logs, ensuring compliance with effective dates and notification timelines, and supporting payer notifications and operational implementations.

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

⛳️ Requirements

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

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

• Strong expertise in 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 skills in Excel required.

• A basic working knowledge of SQL is necessary.

• Capable of building and auditing complex Excel-based financial models, analyzing data, and translating analyses into specific, targeted actions to achieve results.

• Expertise in handling complex and large data sets.

• Demonstrated ability 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 FSA

• Dependent Care FSA

• Limited Healthcare FSA

• FSAs for Transportation and Parking & HSAs

• Matching 401(K) Plan

• Paid family leave

• 9 observed holidays