Payor Pricing Analyst

Develop and maintain financial models evaluating reimbursement methodologies, pricing strategies, and contract performance across commercial, Medicare, and Medicaid payors Analyze reimbursement trends, fee schedules, contract terms, and financial performance to identify pricing opportunities and recommend strategies Support contract negotiations, request-for-proposal responses, and strategic initiatives through reimbursement modeling, financial analysis, and risk assessments Partner with finance, contracting, revenue cycle, clinical, and operational stakeholders to ensure accurate reimbursement configuration, pricing integrity, and data analysis Develop reports, dashboards, and executive-level analyses communicating reimbursement performance, pricing trends, utilization patterns, and strategic recommendations Requirements BA/BS in Finance, Economics, Healthcare Administration, or a related field, or an equivalent combination of education and experience Minimum 3 years of experience in healthcare reimbursement, pricing, specialty pharmacy, infusion services, payor contracting, or financial analytics Experience performing financial modeling Advanced spreadsheet analysis experience MBA or relevant advanced certification preferred Familiarity with PBM and medical benefit billing structures preferred Experience in specialty pharmacy or home/ambulatory infusion preferred Knowledge of 340B pricing impact preferredExperience with claims data analysis and reimbursement reconciliation preferred Experience with contract modeling tools or BI platforms such as Power BI, Tableau, or SQL preferred Core Competencies Demonstrates expertise in financial modeling, reimbursement methodologies, and pricing strategies within the healthcare sector. Proficient in data analysis and contract negotiations, with a strong focus on collaboration across finance, clinical, and operational teams. Highest-signal resume keywords Financial Modeling Healthcare Reimbursement Advanced Spreadsheet Analysis Contract Negotiation Claims Data Analysis ATS Optimization Keywords Hard Skills Financial Modeling Reimbursement Methodologies Pricing Strategies Contract Performance Analysis Data Analysis Soft Skills Collaboration Strategic Thinking Communication Certifications & Qualifications MBA Relevant Advanced Certification Industry Keywords Healthcare Administration Payor Contracting Specialty Pharmacy Infusion Services 340B Pricing Impact Tools & Technologies Power BI Tableau SQL #J-18808-Ljbffr Jobtailor