Provider Contract/Cost of Care Analyst Senior
Core
Analytical support to Cost of Care and Provider Contracting organizations to lower claims costs, improve care quality, and increase member/provider satisfaction.
Role type
Senior Cost of Care and Provider Contracting Analyst
Builds
Defensible pricing strategies, cost savings targets, and contract scenarios for medical services
Domain
Health insurance / Health economics
Deliverable
production ML models | dashboards & analysis
Required skills
Healthcare cost analysis, ROI modeling, PMPM trending, statistical analysis, financial profitability analysis, contract scenario modeling, practice pattern analysis, policy recommendation
Preferred skills
Master's degree in relevant field
Technologies
Statistical analysis tools, healthcare modeling software
Responsibilities
Develop moderately complex ROI models and perform healthcare cost analysis; Project cost increases using PMPM trending; Prepare pre-negotiation analyses for pricing strategies; Model contract scenarios based on member utilization; Measure cost impact of negotiation proposals; Research provider financial stability and competitive environment; Identify cost savings opportunities via practice pattern analysis; Review post-implementation results to ensure savings are realized; Recommend standardized practices to optimize cost of care; Educate provider contractors on contracting analytics; Recommend alternative contract language for negotiations.
Seniority
Senior, hands-on IC
