Job Description

Sr. Pricing Analyst

Cancer care is all we do

Hope in healing

Cancer Treatment Centers of America® (CTCA®) takes a unique and integrative approach to cancer care. Our patient-centered care model is founded on a commitment to personalized medicine, tailoring a combination of treatments to the needs of each individual patient. At the same time, we support patients’ quality of life by offering therapies designed to help them manage the side effects of treatment, addressing their physical, spiritual and emotional needs, so they are better able to stay on their treatment regimens and get back to life. At the core of our whole-person approach is what we call the Mother Standard® of care, so named because it requires that we treat our patients, and one another, like we would want our loved ones to be treated. This innovative approach has earned our hospitals a Best Place to Work distinction and numerous accreditations. Each of us has a stake in the successful outcomes of every patient we treat.

Job Description:

The Senior Pricing Analyst has the responsibility of developing financial tools and contract models providing essential analytical support of CTCA payer and employer contracts.  Major areas of focus include payer contract modeling, decision support of contract negotiations, and operational reports focused on the modeling of contracts. This information will be used in the development of pricing strategies and contract negotiations across the enterprise.  Major areas of focus include contract performance analytics supporting contract integrity across the CTCA system.  This role will support business initiatives through data analysis, translating data into analytics and reporting requirements, data models and deliverables for business programs. Develop and present timely, accurate, actionable data and analysis supporting enterprise wide initiatives.

Job Responsibilities

  • 50%| Develops contract valuation analysis of all implemented and proposed contracts, producing detailed analysis by categories of service, unit price, and utilization metrics.  Maintain a thorough knowledge of reimbursement methodologies, contractual terms, billing, and other operational factors needed supporting negotiations and contract implementations.  Analyze various reimbursement methods and make recommendations supporting pricing strategies.
  • 30%| Track contract performance against expectations, including highlighting areas of concern and provide notations of performance deviation and anomalies. Track and trends audit findings; identifies root cause and communicates findings to appropriate departments.
  • 20%| Perform reviews on pre-executed contracts to provide feedback on potential configuration issues and required clarifications. Support the review and drafting of contractual rate documents within established standards and advises and consults with internal functional departments.

Skills, Education and Additional Information

  • Bachelor’s degree in Business, Healthcare, Analytics, Economics, Finance, or a relevant field. 
  • Relevant graduate degree desirable.
  • Analytical experience in financial analysis, healthcare pricing, healthcare economics, or related discipline.
  • Three or more years’ experience in analytics-related roles
  • Three or more years’ experience in a managed care/healthcare environment
  • Knowledge of claims processing systems and guidelines.
  • Knowledge of HCPCS, CPT, ICD10, and DRG coding.
  • Knowledge of CMS prospective payment systems and reimbursement methodologies.
  • Experience with reimbursement methodologies for Medicare and commercial insurance; and regulatory requirements concerning payer contracts.
  • Analytical skills with the ability to collect, organize, analyze, and disseminate information with attention to detail and accuracy.
  • Ability to independently gather, compile and analyze data and prepare narrative and reports.
  • Produce spreadsheets, documents and presentations that are well-documented and easy to follow (e.g. Excel, PowerPoint).
  • Knowledge and proficiency in Microsoft Word, Excel, Power Point, and Project.
  • Experience in writing SQL required.
  • Experience with using Tableau, QlikView, or similar software required.
  • Strong written and verbal presentation skills including the ability to translate information to a variety of audiences.
  • Ability to follow-through on the execution of tasks and demonstrates an ability to stay the course despite obstacles and challenges.
  • Must have strong interpersonal skills and work well in team settings.
  • Ability to manage conflicting priorities and multiple projects concurrently.
  • Ability to build strong relationships with internal and external stakeholders.
  • Ability to be flexible and adapt to achieve initiative and organizational goals.
#AF-HJ
#LI-RM

We win together

Each CTCA employee is a Stakeholder, driven to make a true difference and help win the fight against cancer. Each day is a challenge, but this unique experience comes with rewards that you may never have thought possible. To ensure each team member brings his or her best self, we offer exceptional support and immersive training to encourage your personal and professional growth. If you’re ready to be part of something bigger and work with a passionate, dynamic group of care professionals, we invite you to join us. 

Visit:  Jobs.cancercenter.com to begin your journey.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

Apply Online