Responsible for supporting and validating Provider Network contracting and unit cost management activities through financial and network pricing modeling, analysis, and reporting. Perform financial modeling to support well-informed negotiations, anticipating issues resulting in the ability to reach contract terms with good faith with sustainability.
The Senior Analyst, Network Pricing requires substantial knowledge with both the conceptual understanding and sufficient professional experience to work on the more complex strategic network pricing and analytics assignments with minimal supervision. In addition, the Senior Analyst may be required to present analytical results at stakeholder meetings.
• Works independently to support and validate Provider Network contracting and unit cost management activities through financial and network pricing modeling, analysis, and reporting.
• Provides subject matter expertise and is accountable for professional functions and/or systems.
• Serves as a key resource on the more complex pricing and analysis issues.
• Reviews work performed by others and provides recommendations for improvement.
• Performs financial modeling of provider contracts (e.g., Medicaid, Medicare, CFAD, ACA Primary Care Enhancement, etc.) in support of well informed negotiations, so that issues can be anticipated and, as a result, contract terms can be reached on good faith with sustainability.
• Works with Contract Leads enterprise-wide to identify unit cost savings opportunities and achieve unit cost targets and contracting initiatives.
• Performs complex conceptual analyses; works to solve complex problems and develop innovative solutions.
• Anticipates client needs and proactively develops solutions to meet them.
• Forecasts and plans resource requirements.
Bachelor's Degree in Business, Finance, Mathematics, Economics or Actuarial Sciences
• 4+ years of analytics experience in financial analysis, healthcare pricing, network management, healthcare economics or related discipline.
• 3+ years of experience with provider payment methodologies and healthcare products
• Experience creating and using spreadsheet, financial modeling and information acquisition tools.
• Experience reviewing and interpreting financial modeling results to evaluate the financial impact of contract changes and develop forecasts.
• Advanced level of proficiency performing financial impact analysis, risk management, and data manipulation.
• Strong verbal and written communication skills.
• Advanced level proficiency in Microsoft Excel and/or Access/SQL.
• Proficiency in Microsoft PowerPoint.
Required License, Certification, Association
• Experience with Trizetto NetworX Modeler/Pricer
• 5+ years experience in healthcare pricing, network management, healthcare economics, or related discipline
• 3+ years experience with provider reimbursement methodologies including, but not limited to, capitation and hospital FFS (Medicaid and Medicare).
Preferred License, Certification, Association
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
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