Senior Healthcare Pricing Consultant

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

📋 Description

• Assist in the financial and pricing analysis of intricate healthcare proposals for a significant federal contract.

• Assess managed-care and healthcare proposal pricing, including rates, unit prices, reimbursement methods, administrative fees, discounts, usage, trends, escalations, and other cost determinants.

• Examine solicitation requirements, evaluation criteria, contract terms, amendments, and procurement documentation.

• Align Offeror pricing submissions with necessary frameworks, contract line items, timeframes, regions, populations, benefit categories, and supporting data.

• Evaluate medical and healthcare pricing information, such as provider reimbursements, claims, usage, network discounts, administrative expenses, regional adjustments, and risk-sharing agreements.

• Create, review, modify, and validate pricing workbooks and models, including formulas, calculations, reconciliations, assumptions, and supporting documentation.

• Standardize and compare competing proposals using historical data, market benchmarks, government statistics, independent assessments, and other resources.

• Detect deficiencies, anomalies, unsupported assumptions, inconsistencies, ambiguities, unbalanced pricing, and potential cost or performance risks.

• Formulate clarification questions, analytical insights, negotiation goals, and fair-and-reasonable pricing recommendations.

• Draft Price Analysis Reports, comparison tables, executive summaries, decision-support documents, and traceable acquisition workpapers.

• Collaborate with healthcare, actuarial, pricing, and acquisition experts during clarifications, proposal adjustments, negotiations, and Final Proposal Revisions while safeguarding procurement-sensitive information.

⛳️ Requirements

• Must currently possess authorization to work in the United States on a full-time basis.

• Capability to secure a Public Trust Security Clearance.

• Bachelor’s degree in Finance, Accounting, Economics, Business, Healthcare Administration, Mathematics, Statistics, or a related field.

• Over 7 years of experience in healthcare pricing, medical pricing, managed-care pricing, reimbursement, healthcare economics, health-plan analytics, provider pricing, or a related discipline.

• More than 3 years of experience assessing healthcare pricing, rates, reimbursement, provider or network pricing, cost models, or related financial analyses.

• Practical experience in building, modifying, validating, or independently reviewing complex pricing models and their supporting data.

🏝️ Benefits

• Major medical benefits.

• Dental coverage.

• Vision coverage.

• 401(k) contribution plan.

• Holiday and personal time off.

• Professional development training and certification benefits.

• Health and wellness subsidies.

• Paid time off for community service.

• Reasonable accommodations may be provided for individuals to perform essential job functions.