Sr Contract Pricing Advisor

HCA • Brentwood, TN

74d

About The Position

The Strategic Pricing Services (SPS) Senior Contract Pricing Advisor is responsible for the What-if modeling of the more advanced managed care contracts and performance of advanced ad hoc analyses partnering with Payer Contracting & Alignment in creating payer contracts to ensure HCA's competitive position in the market. The Sr. Contract Pricing Advisor will use financial modeling tools to evaluate the impact of proposed terms on profitability, trend and other metrics.

Requirements

• Bachelor's degree preferred.
• Minimum 2+ years experience preferred.
• 1+ year(s) of experience in Healthcare / Managed Care preferred.
• Ability to manage project work.
• Required understanding of gross/net revenue, and managed care payors.
• Working knowledge of managed care contracting and modeling preferred.
• Experience working with claim data and familiarity with standard medical coding such as CPT, ICD10, HCPC and/or DRGs preferred.
• Experience with Microsoft Office, Excel, Access, relational databases, and reporting tools preferred.

Responsibilities

• In partnership with PCA contracting, assist in contract pricing in a strategic manner and offer meaningful options during negotiations with a payer.
• Partner with Payer Contracting & Alignment resources to quantify impact of changes to payer contracts.
• Summarize and explain findings and recommendations to drive decision making.
• Model more advanced managed care contracts through the Alliance for Decision Support system (ADS).
• Understand and analyze CDM price increases to determine the effect on contract modeling, negotiations, and net revenue projections.
• Organize and analyze results data providing summary of findings to Manager and/or Consulting Advisor.
• Provide ad hoc analysis and deep dives into data as appropriate to support negotiation strategy and provide value to our contracting partners.
• Assist in the design, development and implementation of advanced ad hoc reports.
• Assist in identifying and documenting reporting requirements.
• Based on data sources identified, extract and manipulate data from databases.
• Assist with performing acceptance and QA testing as applicable.
• Keep management informed as to progress of pricing exercises and proactively identify risk and opportunities for meeting exercise goals (both time and net impact).
• Work with SSC / Concuity modelers and Contracting partners to oversee modeling corrections and updates to pricing models.
• As requested works with Consulting Contract Pricing Advisor in completing retrospective review of contracts to analyze negotiated rate of reimbursement compared to actual net revenue results with variance explanation.
• Uses data mining tools to assist customers effectively with data requests.
• Assist Financial Analyst & Contract Pricing Advisors with training and education of new staff and as appropriate for PCA.
• Participate in departmental training and professional development opportunities when available.
• Adds value to APS by producing accurate results, working efficiently, and continuing to grow in the position.

Benefits

• Comprehensive medical coverage that covers many common services at no cost or for a low copay.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans, auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
• Free counseling services and resources for emotional, physical and financial wellbeing.
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service).
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock.
• Family support through fertility and family building benefits with Progyny and adoption assistance.
• Referral services for child, elder and pet care, home and auto repair, event planning and more.
• Consumer discounts through Abenity and Consumer Discounts.
• Retirement readiness, rollover assistance services and preferred banking partnerships.
• Education assistance (tuition, student loan, certification support, dependent scholarships).
• Colleague recognition program.
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence).
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

What This Job Offers

• Career Level: Mid Level
• Industry: Hospitals
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees