Job Description

Senior Pricing Analysts - Texas Health Resources
Bring your passion to Texas Health so we are Better + Together
Work Location: Texas Health Corporate, 612 E. Lamar Blvd., Arlington, TX 76011 - 10th Floor
Work Hours: Full Time Days (8:00am-5:00pm) for 40 hrs/week (remote work allowed at manager's discretion)
Department Highlights:

• Hybrid Position
• Gain a sense of accomplishment by contributing to a teamwork environment.
• Receive excellent mentorship, comprehensive training, and dedicated leadership resources.
• Contribute and work on a cross functional team
• Opportunity to work with leaders across THR/THPG

Strategic Pricing and Modeling:
Lead, develop and enhance pricing analysis for hospitals, behavioral health, long term acute care hospital, ambulatory surgery centers, imaging centers, urgent care, home infusion, virtual care, physicians, and other provider types to develop pricing strategies.
Develop and present opportunities and recommendations of managed care, market trends, and pricing landscape to senior leadership as subject matter expert.
Lead analysis of market trends, competitor pricing, industry benchmarks, payor contracts, financial performance, profitability of service lines, and cost of care to drive pricing decisions and identify opportunities for price optimization and competitive advantage.
Design, implement, and continuously optimize robust databases and data management systems to support business needs, strategic pricing, price transparency and market analysis initiatives.
Utilize contract management and pricing tools to create scenario-based frameworks and models to simulate pricing scenarios, forecast reimbursement trends and forecast financial impact.
Collaborate with payor operations, finance, revenue cycle, chargemaster, ITS, managed care, and entities to align pricing models with financial, operational, and strategic objectives.
Prepare dashboards and reports to deliver actionable insights to support executive decision-making, including payor performance, service line, variance analysis, reimbursement trends, and pricing performance metrics.
Conduct market research to understand industry trends, competitor pricing, and payor payment policies.
Provide analytical support for payor contract negotiations and renewals to execute pricing strategies aligned with Texas Health???s strategic growth objectives.
Model commercial and government reimbursement proposals.
Receive, validate, and distribute payor fee schedule updates in a timely manner.
Ability to create ad hoc financial modeling and reports
Work with complex dataset.
Mentor Pricing Analysts. 40%
Risk Contract Analysis:
Conduct in-depth analysis of innovative pricing models???including value-based care, bundled payments, tiered pricing, risk-sharing arrangements, alternative payment methodologies, and package pricing???to identify opportunities for financial optimization, support strategic decision-making, and advance organizational goals.
Coordinate with teams to audit contract management tools and systems that use contracted rates to ensure rates and expected net revenue are accurate.
Lead development of analysis and present global pricing opportunities and recommendations, such as transplant and other service lines to senior leadership as system subject matter expert. 30%
Transparency and Compliance:
Support generation of machine readable files (MRF) or collaborate closely with a vendor partner.
Continuous education on government reimbursement methodology, calculations, and reimbursement.
Validate compliance with federal and state regulations related to pricing transparency (e.g. CMS Hospital Price Transparency Rule, machine readable files, shoppable services, No Surprises Act).
Support internal audits and compliance reviews related to pricing and reimbursement. 10%
Other Projects
Lead special projects related to reimbursement strategy, service line pricing, margin optimization and price transparency.
Provide data-driven insights to support pricing decisions for new services, bundled payments, value based care, and alternative payment models.
Provide analysis and recommendations for service line pricing and margins using market research.
Other projects and duties as assigned 20%
What You Need:
Education
Bachelor's Degree Business, Accounting, Finance, Data Science, or related field Req
Master's Degree MBA, MHA, Health Care Administration, Finance, Data Science or related advanced degree 2 additional years of experience in lieu of Masters degree Req
Experience
5 Years Decision support, financial analysis, healthcare pricing, managed care analytics, or revenue cycle to include SQL or relational database experience and/or reimbursement methodologies. Req
Contract Modeling Experience, SQL Experience, Knowledge of DFW Managed Care Market. Preferred
Education
Bachelor's Degree Business, Accounting, Finance, Data Science, or related field Req
Master's Degree MBA, MHA, Health Care Administration, Finance, Data Science or related advanced degree 2 additional years of experience in lieu of Masters degree Req
Experience
5 Years Decision support, financial analysis, healthcare pricing, managed care analytics, or revenue cycle to include SQL or relational database experience and/or reimbursement methodologies. Req
Contract Modeling Experience, SQL Experience, Knowledge of DFW Managed Care Market. Preferred
Skills
Ability to conduct and train team members in in-depth quantitative research, build and maintain complex pricing models, and translate data into actionable insights.
Proficiency with pricing, database, and modeling platforms such as SQL, Excel, Access, Tableau, Power BI, Alteryx, Excel, Access, or other relational databases.
Demonstrates strong expertise in healthcare pricing and claim systems; advanced knowledge in these areas is highly valued.
Excellent communication and people skills, with the ability to collaborate with cross-functional teams.
Knowledge of industry regulations and compliance requirements related to managed care pricing.
Critical thinking skills, strong math and computer aptitudes, presentation skills
Ability to manage multiple priorities in a fast-paced environment.
Knowledge of hospital, ancillary and physician reimbursement methodologies.
Supervision
Individual Contributor
ADA Requirements
Working Indoors 67% or more
Physical Demands
Sedentary

Skills Required