Pricing Analyst III

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⛰️ Colorado – Remote

⛰️ Colorado – Remote

💵 $69.9k - $90k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💰 Pricing Analyst

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Modivcare

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 2017

⚕️ Healthcare Insurance

🚗 Transport

💰 $525M Post-IPO Debt on 2024-07

Healthcare Insurance • Transport

Modivcare is a company that focuses on simplifying the experience of living with complex healthcare needs by providing a comprehensive suite of supportive care solutions. They specialize in non-emergency medical transportation, personal care, and virtual & remote patient monitoring. Modivcare works closely with Medicaid Plans, State Agencies, Medicare Advantage, SNP Plans, health systems, healthcare professionals, and transportation providers, ensuring that members receive necessary health services. Through innovative technology and data-driven strategies, they address social determinants of health by offering services like quality transportation, chronic care management, meal delivery, and in-home assistance, aimed at optimizing patients' health outcomes and improving their overall experience.

📋 Description

• Develops, maintains, and enhances NEMT pricing models for new business opportunities, renewals, repricing events, RFP responses, and contract amendments. • Analyzes contract terms and conditions to identify pricing implications, financial risks, reimbursement mechanics, service obligations, and margin impacts. • Collaborates with cross-functional teams to develop pricing proposals and financial models for clients. • Builds and maintains account-level and market-level income statement views that compare original pricing assumptions to monthly, quarterly, and year-to-date actual results, monitoring contract performance to ensure pricing and performance alignment. • Evaluates key financial and operational metrics by contract, market, and contract type. • Supports RFP pricing by translating operational requirements into financial assumptions, including staffing, transportation network needs, provider reimbursement, reporting requirements, implementation complexity, technology needs, service levels, and compliance obligations. • Analyzes pricing and profitability across various contract structures, including full-risk, shared-risk, fee-for-service, capitation, and ASO arrangements. • Identifies and evaluates cost drivers that impact pricing and margin performance. • Conducts advanced analysis of large and complex data sets to identify trends, utilization anomalies, margin leakage, and pricing opportunities. • Prepares pricing reports, variance analyses, executive summaries, dashboards, and presentations for senior management and cross-functional stakeholders. • Maintains accurate pricing databases, assumption libraries, model documentation, and data sources to support reporting, auditability, and repeatable processes. • Partners with Network and Operations teams to understand provider capacity, local market dynamics, transportation supply constraints, rate adequacy, and fair market cost drivers while supporting 'should cost' rate benchmarking. • Collaborates with Revenue Cycle and Encounters teams to understand claims, denials, payment reconciliation, encounter submission, and revenue integrity impacts on contract economics. • Recommends process improvements to optimize pricing workflows, data quality, model governance, reporting, and post-award feedback loops. • Stays current on NEMT, Medicaid, Medicare Advantage, managed care, healthcare transportation, regulatory requirements, and market dynamics that may influence pricing strategies. • Performs other duties and may lead projects as assigned.

🎯 Requirements

• Bachelor's degree required, preferably in Finance, Accounting, Economics, Business Analytics, Data Analytics, Statistics, Mathematics, Healthcare Administration, or a related field. • Five (5) or more years of experience in pricing, financial analysis, data analytics, FP&A, healthcare analytics, managed care analytics, transportation analytics, or a related field. • Experience supporting RFPs, renewals, pricing events, contract repricing, financial modeling, or client proposals strongly preferred. • Experience in Non-Emergency Medical Transportation (NEMT), Medicaid, Medicare Advantage, managed care, healthcare services, transportation, logistics, or provider network operations preferred or equivalent combination of education and/or experience. • Strong understanding of pricing strategies, methodologies, financial modeling, and profitability analysis. • Strong financial acumen, including the ability to understand income statements, revenue, gross profit, adjusted EBITDA, margin, cost drivers, and variance analysis. • Ability to analyze contract terms and translate commercial, operational, and service-level obligations into pricing and financial implications. • Advanced analytical and problem-solving skills with the ability to work with large, complex data sets. • Advanced proficiency in Microsoft Excel, including scenario modeling, sensitivity analysis, advanced formulas, pivot tables, lookup functions, and model documentation. • Proficiency with SQL, data warehouse queries, Python, R, or similar analytical tools preferred. • Experience with data visualization tools such as Power BI, Tableau, or similar platforms preferred. • Ability to conduct advanced analyses to identify trends, patterns, utilization changes, financial variances, and performance drivers. • Ability to distinguish fixed, variable, semi-variable, and controllable costs within a services-based operating model. • Understanding of contract structures such as full-risk, shared-risk, fee-for-service, capitation, administrative fee, and corridor arrangements preferred. • Familiarity with NEMT, managed care, Medicaid, Medicare Advantage, healthcare services, transportation, logistics, or provider network economics preferred. • Ability to build clear, repeatable, and auditable pricing models with documented assumptions. • Ability to communicate technical and financial findings effectively to non-technical stakeholders. • Strong presentation skills with the ability to explain pricing recommendations clearly and persuasively. • Ability to collaborate effectively across cross-functional teams. • Strong attention to detail and commitment to data accuracy, documentation, and quality. • Ability to handle confidential financial, client, pricing, and contract information with discretion. • Ability to manage competing priorities in a fast-paced, deadline-driven environment. • Ability to challenge assumptions constructively and recommend practical improvements to pricing, processes, and reporting. • Ability to work independently while maintaining strong alignment with stakeholders.

🏖️ Benefits

• Medical, Dental, and Vision insurance • Employer Paid Basic Life Insurance and AD&D • Voluntary Life Insurance (Employee/Spouse/Child) • Health Care and Dependent Care Flexible Spending Accounts • Pre-Tax and Post --Tax Commuter and Parking Benefits • 401(k) Retirement Savings Plan with Company Match • Paid Time Off • Paid Parental Leave • Short-Term and Long-Term Disability • Tuition Reimbursement • Employee Discounts (retail, hotel, food, restaurants, car rental and much more!)