Network Pricing Associate - Healthcare Network Contracting

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

The Network Pricing Analyst will collaborate with team members and other stakeholders toward delivering needed network financial guidance to the organization.

Responsibilities:

• Develop analyses that support the identification of meaningful medical and pharmacy cost trends, collaborating with subject matter experts to identify root causes of trends.
• Support the Network team with validation of Medicaid/Medicare/Exchange pricing, collaborating with internal partners as well as external consultants and vendors.
• Assist in the development of financial forecasts and projections.
• Support the creation of internal and external benchmarks.
• Participate in strategic discussions and supports strategies for healthy and sustainable growth.
• Developing contract impact and termination models, presentation materials and communicating results of financial, rate, and payment term analyses to various stakeholders.
• Help drive the creation and utilization of better systematic and standardized payment term analytics and leveraging of this information to unlock value opportunities and insights around Chargemasters, Outliers and Outlier Thresholds, Fee Schedules, and Grouper information.
  
  

Qualifications / Education:

• At least three (3) years of experience.
• Experience mining large data sets.
• Advanced capabilities in Excel, SAS/SQL, and database applications used for analysis, proficiency with Microsoft PowerPoint.
• Programming experience in Python & R is a plus.
• At least four (4)+ years’ experience working in health care and/or Medicaid/ACA products.
• Problem solving skills, including the ability to work independently and systematically analyze complex problems, draw relevant conclusions, and successfully devise/implement solutions calmly and effectively.
• Excellent written and verbal communication skills as well as strong data presentation skills.
• Established ability to manage multiple initiatives, shifting back and forth effectively among activities, to produce positive results in a dynamic environment.
• Bachelor’s Degree
  
  

Diversity, Equity, and Inclusion

At Amerihealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

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