Network Pricing Consultant(Job Number:706512)
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The Network Pricing Consultant supports and validates Provider Network (physicians, hospitals, pharmacies, ancillary facilities, etc.) contracting and unit cost management activities through financial and network pricing modeling, analysis, and reporting. Network Pricing Consultants conduct unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies. Responsibilities also include managing unit cost budgets, target setting, performance reporting, and associated financial models.
In this role you will be expected to:
- Anticipate customer needs and proactively develop solutions to meet them.
- Serve as a key resource on complex and/or critical issues.
- Solve complex problems and develop innovative solutions.
- Perform complex conceptual analyses.
- Review work performed by others and provide recommendations for improvement.
- Forecast and plan resource requirements.
- Authorize deviations from standards.
- May lead functional or segment teams or projects.
- Provide explanations and information to others on the most complex issues.
- Motivate and inspire other team members.
Candidate will support web-based financial modeling applications used to evaluate provider contracts, and other business applications, tools, and reports. Key responsibilities include:
- Interpreting complex provider reimbursement language and methodologies.
- Analyzing claims and provider data from multiple claims platforms.
- Preparing detailed business requirements that provide the framework for enhancements to the application.
- Working closely with the Network Pricing leadership and other Network Pricing Analysts to define the business requirements and with the technology team responsible for executing the business requirements.
- Testing the enhancements as they are implemented using appropriate error checking strategies to ensure validity and reliability.
- Documenting the enhancements.
- Managing against a detailed project plan.
- Providing user training, education, and support.
Job Network Pricing
Primary Location US-MD-Rockville
Other Location United States, US-MN-Eden Prairie
Organization E&I HCE Network Pricing
Number of Openings 1