Pricing Analysts - Texas Health Resources

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

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

What You Will Do:

Strategic Pricing and Modeling:

Analyze pricing 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.

Analyze 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.

Develop and maintain 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, 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. Strategic growth objectives.

Model commercial and government reimbursement proposals.

Receive, validate, and distribute payor fee schedule updates in a timely manner.

Risk Contract Analysis:

Assist with analysis related to innovative pricing models, including value-based care arrangements, bundled payments, tiered pricing, risk-sharing arrangements, alternative payment methodologies, and package pricing, where appropriate.

Audit contract management tools and systems that use contracted rates to ensure rates and expected net revenue are accurate.

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.

Other Projects:

Assist 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

What You Need:

Education

Bachelor's Degree Business, Accounting, Finance, Data Science, or related field Req

Experience

3 Years Decision support, financial analysis, healthcare pricing, managed care analytics, or revenue cycle to include experience with Microsoft Excel and Access or relational database experience and/or reimbursement methodologies. Req

Strong analytical and critical thinking skills, Proficiency in Microsoft Excel and Access, Experience with SQL, Familiarity with Healthcare coding (CPT, ICD-10), knowledge of managed care methodologies and their impact across different provider types, Experience with healthcare claims (Facility and Professional), knowledge of physician reimbursement. Pref

Education

Bachelor's Degree Business, Accounting, Finance, Data Science, or related field Req

Experience

3 Years Decision support, financial analysis, healthcare pricing, managed care analytics, or revenue cycle to include experience with Microsoft Excel and Access or relational database experience and/or reimbursement methodologies. Req

Strong analytical and critical thinking skills, Proficiency in Microsoft Excel and Access, Experience with SQL, Familiarity with Healthcare coding (CPT, ICD-10), knowledge of managed care methodologies and their impact across different provider types, Experience with healthcare claims (Facility and Professional), knowledge of physician reimbursement. Pref

Skills

Ability to conduct in-depth quantitative research, build and maintain complex pricing models, and translate data into actionable insights.

Experience with pricing, database, and modeling platforms such as SQL, PMMC, EPSI, Tableau, Power BI, Alteryx, Excel, Access, or other healthcare pricing and claim systems is a plus.

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

Texas Health requires a resume when an application is submitted.Employment opportunities are only reflective of wholly owned Texas Health Resources entities.

We are an Equal Opportunity Employer and do not discriminate against any employees or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.