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Payor Pricing Analyst
Elevance Health. Develop and maintain financial models evaluating reimbursement methodologies, pricing strategies, and contract performance across commercial, Medicare, and Medicaid payors .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in financial modeling, reimbursement methodologies, and pricing strategies within the healthcare sector. Proficient in data analysis and contract negotiations, with a strong focus on collaboration with cross-functional teams.
Highest-signal resume keywords
Financial ModelingHealthcare ReimbursementContract NegotiationClaims Data AnalysisAdvanced Spreadsheet Analysis
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Financial AnalysisReimbursement MethodologiesPricing StrategiesContract Performance EvaluationRisk Assessment
Soft Skills
CollaborationCommunicationStrategic Thinking
Tools & Technologies
Power BITableauSQL
Certifications & Qualifications
MBARelevant Advanced Certification
Industry Keywords
MedicareMedicaidPBM340B PricingSpecialty PharmacyInfusion ServicesPayor Contracting
Tech Stack
Tools & technologiesSQLTableau
About the role
Key responsibilities & impact- Develop and maintain financial models evaluating reimbursement methodologies, pricing strategies, and contract performance across commercial, Medicare, and Medicaid payors
- Analyze reimbursement trends, fee schedules, contract terms, and financial performance to identify pricing opportunities and recommend strategies
- Support contract negotiations, request for proposal responses, and strategic initiatives through reimbursement modeling, financial analysis, and risk assessments
- Partner with finance, contracting, revenue cycle, clinical, and operational stakeholders
- Ensure accurate reimbursement configuration, pricing integrity, and data analysis
- Develop reports, dashboards, and executive-level analyses communicating reimbursement performance, pricing trends, utilization patterns, and strategic recommendations
- Support the Director of Pricing
Requirements
What you’ll need- BA/BS in Finance, Economics, Healthcare Administration, or a related field
- Minimum of 3 years of experience in healthcare reimbursement, pricing, specialty pharmacy, infusion services, payor contracting, or financial analytics
- Requires experience performing financial modeling and advanced spreadsheet analysis
- MBA or relevant advanced certification preferred
- Familiarity with PBM and medical benefit billing structures
- Experience in specialty pharmacy or home/ambulatory infusion
- Knowledge of 340B pricing impact
- Experience with claims data analysis and reimbursement reconciliation
- Experience with contract modeling tools or BI platforms such as Power BI, Tableau, or SQL
- Must reside within a reasonable commuting distance from one of the posting locations unless an accommodation is granted as required by law
Benefits
Comp & perks- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical benefits
- Dental benefits
- Vision benefits
- Short-term disability benefits
- Long-term disability benefits
- 401(k) with company match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
- Hybrid work arrangement with in-office work 1–2 days per week and flexibility for virtual work