Sr. Financial Analyst - Health Plan Pricing (Hybrid)
Quest Diagnostics
- Secaucus, NJ
- Permanent
- Full-time
- Performs all financial analyses required for prospective third-party contracts including the compilation of fee schedules, revenue projections, synergy analyses and “what-if” scenarios
- Calculates specific CAP PMPM rates and develops CPT based fee schedules for key regional and national contracts
- Develops utilization and membership corridors and integrates such corridors into contracts where applicable to protect the Company from downstream risk with capitated arrangements
- Supports the development of standard premium priced tests, capitation carve-outs and overall pricing guidelines
- Works closely with the Clinical Franchise department to ensure that pricing guidelines for high value and new test campaigns are considered in prospective contracts
- Serves as a content expert to regional leadership regarding third party contracts and pricing strategies
- Interfaces directly with regional leadership regarding the price, volume, and cost implications associated with new and existing third-party contracts
- Develops methods to streamline the pricing review and authorization process for third-party contracts
- Performs specific test campaign analyses to determine the prospective revenue and volume impact for key test initiatives
- Partners with Billing function to review, disseminate, and recommend enhancements to third-party data used to build financial models
- Supports the annual budget process providing details and insights on known and potential contract changes in the coming year
- Ad-hoc projects as needed
- Bachelor’s degree
- Minimum of three years relevant financial analysis experience
- Strong understanding of the healthcare industry and health plans specifically (product types, trends, etc.)
- Strong financial and analytical skills
- Innovative thinker comfortable with ambiguity to complete tasks
- Ability to work effectively cross-functionally in a matrix environment and build/maintain relationships
- Excellent verbal and written communication skills
- Ability to work effectively both independently and within a team
- Strong PC skills (Excel, Access, PowerPoint, Word)