Pricing Analyst III

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

📋 Description

• Develops, maintains, and enhances pricing models for Non-Emergency Medical Transportation (NEMT) focusing on new business opportunities, renewals, repricing events, RFP responses, and contract modifications.

• Analyzes the terms and conditions of contracts to pinpoint pricing ramifications, financial risks, reimbursement mechanics, service responsibilities, and margin effects.

• Works in collaboration with cross-functional teams to create pricing proposals and financial models tailored for clients.

• Constructs and sustains income statement views at both account and market levels, comparing initial pricing assumptions with actual results on a monthly, quarterly, and year-to-date basis, while monitoring contract performance to ensure alignment of pricing and outcomes.

• Assesses essential financial and operational metrics categorized by contract, market, and contract type.

• Aids in RFP pricing by converting operational needs into financial assumptions that encompass staffing, transportation network requirements, provider reimbursement, reporting obligations, implementation challenges, technology necessities, service standards, and compliance duties.

• Examines pricing and profitability across diverse contract frameworks, including full-risk, shared-risk, fee-for-service, capitation, and Administrative Services Only (ASO) arrangements.

• Identifies and evaluates cost drivers influencing pricing and margin performance.

• Conducts thorough analyses of extensive and intricate data sets to uncover trends, utilization anomalies, margin leakage, and pricing opportunities.

• Prepares pricing reports, variance analyses, executive summaries, dashboards, and presentations for senior management and cross-functional stakeholders.

• Maintains precise pricing databases, assumption libraries, model documentation, and data sources to support reporting, auditability, and consistent processes.

• Partners with Network and Operations teams to gain insights into provider capacity, local market conditions, transportation supply limitations, rate adequacy, and fair market cost drivers while assisting with 'should cost' rate benchmarking.

• Collaborates with Revenue Cycle and Encounters teams to comprehend claims, denials, payment reconciliation, encounter submission, and revenue integrity impacts on contract economics.

• Suggests process enhancements to streamline pricing workflows, data quality, model governance, reporting, and post-award feedback mechanisms.

• Remains updated on NEMT, Medicaid, Medicare Advantage, managed care, healthcare transportation, regulatory requirements, and market dynamics that may impact pricing strategies.

• Performs additional duties and may lead projects as assigned.

⛳️ Requirements

• A Bachelor's degree is required, preferably in Finance, Accounting, Economics, Business Analytics, Data Analytics, Statistics, Mathematics, Healthcare Administration, or a related field.

• Five (5) or more years of experience in pricing, financial analysis, data analytics, financial planning & analysis (FP&A), healthcare analytics, managed care analytics, transportation analytics, or a related field.

• Experience in supporting RFPs, renewals, pricing events, contract repricing, financial modeling, or client proposals is strongly preferred.

• Familiarity with Non-Emergency Medical Transportation (NEMT), Medicaid, Medicare Advantage, managed care, healthcare services, transportation, logistics, or provider network operations is preferred or an equivalent combination of education and/or experience.

• A solid understanding of pricing strategies, methodologies, financial modeling, and profitability analysis.

• Strong financial acumen, including the ability to interpret income statements, revenue, gross profit, adjusted EBITDA, margin, cost drivers, and variance analysis.

• Capability to analyze contract terms and convert commercial, operational, and service-level obligations into pricing and financial implications.

• Advanced analytical and problem-solving skills with the ability to navigate large, complex data sets.

• High proficiency in Microsoft Excel, including scenario modeling, sensitivity analysis, advanced formulas, pivot tables, lookup functions, and model documentation.

• Proficiency with SQL, data warehouse queries, Python, R, or similar analytical tools is preferred.

• Experience with data visualization tools such as Power BI, Tableau, or similar platforms is preferred.

• Ability to conduct advanced analyses to detect trends, patterns, changes in utilization, financial variances, and performance drivers.

• Ability to differentiate between fixed, variable, semi-variable, and controllable costs within a service-based operating model.

• Familiarity with contract structures such as full-risk, shared-risk, fee-for-service, capitation, administrative fee, and corridor arrangements is preferred.

• Knowledge of NEMT, managed care, Medicaid, Medicare Advantage, healthcare services, transportation, logistics, or provider network economics is preferred.

• Ability to construct clear, repeatable, and auditable pricing models with documented assumptions.

• Proficient in effectively communicating technical and financial findings to non-technical stakeholders.

• Strong presentation skills with the ability to articulate pricing recommendations clearly and persuasively.

• Capacity to collaborate effectively across cross-functional teams.

• Excellent attention to detail and commitment to data accuracy, documentation, and quality.

• Ability to manage confidential financial, client, pricing, and contract information with discretion.

• Ability to juggle competing priorities in a fast-paced, deadline-driven environment.

• Capability to constructively challenge assumptions and propose practical improvements to pricing, processes, and reporting.

• Ability to work independently while ensuring strong alignment with stakeholders.

🏝️ Benefits

• Medical, Dental, and Vision insurance

• Employer Paid Basic Life Insurance and Accidental Death & Dismemberment (AD&D)

• Voluntary Life Insurance (Employee/Spouse/Child)

• Health Care and Dependent Care Flexible Spending Accounts

• Pre-Tax and Post-Tax Commuter and Parking Benefits

• 401(k) Retirement Savings Plan with Company Match

• Paid Time Off

• Paid Parental Leave

• Short-Term and Long-Term Disability

• Tuition Reimbursement

• Employee Discounts (retail, hotel, food, restaurants, car rentals, and much more!)