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Senior Pricing Analyst - Group Health Experience in Jacksonville, FL at One Call

Date: 1/9/2019

Job Snapshot

Job Description

Senior Pricing Analyst - Group Health Experience


The Pricing/Data Analyst is responsible for compiling and analyzing the company’s historical cost and payment data by product along with reimbursement rates set by the Workman’s Compensation State Fee Schedules, Medicaid and Medicare Fee Schedules. They will provide data and analyses to executive management in order to support market expansion and pricing decisions for health plan contracts as well as associated vendor contracting.

GENERAL DUTIES & RESPONSIBILITIES:

• Analyze health plan pricing in all applicable systems, based on various forms of data and research.
• Analyze various pricing benchmarks and performs comparative analysis to various fee schedules and vendor costs.
• Analyze Health Plan Pricing and updating all necessary documentation to assist with the Request for Proposal process.
• Design and build pricing models to measure and analyze margins at various price points to support pricing decisions.
• Determine Vendor Cost Analysis and Vendor Cost Targets.
• Coordinate with Pricing Implementation coordinator, the maintenance of the SharePoint page for Vendor and Health plan pricing upon approval by sales/executive management.
• Update and maintain benchmark data for analysis including State Fee Schedule tables, Ingenix U&C Data, and Medicare and Medicaid Allowable data, working closely with compliance to keep the data as current as possible.
• Assist with specific projects and analysis as required
• Completion of any projects or analysis requested by the Manager or division VP.
• General clerical duties as needed.

EDUCATIONAL REQUIREMENTS:

Bachelor’s degree (B.A. or B.S.) in Business or Finance preferred or equivalent combination of education and work experience.  Prior analytical experience including cost analysis and healthcare reimbursement methodologies.   Medicaid and Medicare reimbursement/billing required. 

GENERAL KNOWLEDGE, SKILLS & ABILITIES:

• Experience with databases and building queries using Microsoft Access or SQL.
• Data entry skills/above average speed with minimal errors.
• Advanced Microsoft Office (SharePoint, Word, Excel, PowerPoint, Access). 
• Strong organization skills. 
• Must be extremely detailed oriented and able to work independently as well as in a team environment. 
• The ability to follow precise instructions and meet strict deadlines.
• Excellent interpersonal skills, as the position requires effective interactions with various levels of personnel.
• Strong analytical skills.

PHYSICAL/EMOTIONAL DEMANDS & WORK ENVIRONMENTS:

• For roles located in office or home settings; this job is primarily sedentary and may involve repetitive motions; the employee is regularly required to sit, use hands and fingers, speak, and hear
• For roles located in the field; this job is primarily active; the employee is regularly mobile and must be able to utilize transportation (such as driving), sit, use hands and fingers, speak, and hear
• The employee is occasionally required to stand, walk, and lift objects (up to 10 lbs. weight; up to 4 ft. height)
• Specific vision abilities required by this job include ability to see things from a close distance and ability to adjust focus
• The work environment utilizes florescent lighting; noise level is moderate
• The emotional demand of the job may cause undue stress from, but not limited to, moderate/heavy workload
• Reasonable accommodations will be individually assessed and possibly made to enable individuals with disabilities to perform the essential functions of the position
• Please be advised the job description is subject to change at any time


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