Job Title: Payer Pricing & Data Analyst
Reports To: Director of Data Engineering and Operations
Location: Remote/Virtual (U.S.-based) with travel required for up to five meetings per year (~7% FTE) Candidates must be able to work primarily within East Coast, Central Time Zone or Mountain time business hours.
Position Type: Full-Time, Exempt
Position Summary:
The Healthcare Payer Pricing & Data Analyst supports payer and manufacturer contract negotiations, pricing strategies, and opportunity assessments. This individual will work across departments and with external partners to analyze pricing data, project cost savings and revenue potential, support the development of pricing and strategy recommendations and support the contracting process.
This role is well‑suited for someone who excels in a fast‑moving, mission‑driven environment and is energized by wearing multiple hats—ranging from deep analytical work to coordinating complex projects within a matrixed, cross‑functional team structure.
How To Apply:
- Must submit a cover letter and resume
- No phone calls please
Key Responsibilities:
Pricing & Savings Analysis
- Analyze payer, prescription benefit manager and manufacturer pricing to assess potential opportunities and savings.
- Calculate ROI and cost savings for broker and client stakeholders as well as other potential clients including but not limited to employers, insurers and Pharmacy Benefit Managers (PBMs); model revenue potential for internal use.
- Maintain and update Hemophilia Alliance Network Services (HANS) fee schedules at least annually and adjust as needed using a variety of methods including average sales price and average wholesale price
- Perform competitive pricing analysis quarterly and as needed to determine best commercial price and maintain market intelligence.
- Forecast expected payer pricing based on market trends, contracts, and historical data.
- Work collaboratively to gather data from Member and Community Relations team members.
- Assist Member and Community Relations team with supportive opportunity data for Hemophilia Treatment Centers (HTCs) that includes revenue and surplus projections.
Contract Support & Negotiation Analytics
- Partner with the Member and Community Relations Team to manage Single Case Agreement (SCA) renewals and renegotiations, particularly in response to price increases.
- Use contract lifecycle management (CLM) software to monitor SCAs.
- Support contract development with Medicare Advantage Plans and commercial payers by providing data-driven floor pricing and contract targets.
- Provide data insights to inform negotiation strategy with payers and manufacturers.
Opportunity Assessment & Strategic Insights
- Maintain and refine an Opportunities Dashboard with de-identified claims data to track pipeline and outcomes.
- Analyze payer data to identify volume return opportunities and inform contracting priorities.
- Support opportunity identification using NPI search tools and cross-reference with internal dispensing data.
- Identify dispensing capabilities across contract pharmacy networks for payer/provider alignment.
Data Management & Reporting
- Maintain relevant datasets including the Member and Community Relations (MCR) and payer claims worksheets.
- Develop and maintain reports and dashboards using Excel, Power BI, or similar tools to communicate findings with internal and external stakeholders.
- Ensure data accuracy and conduct validation and quality assessment (QA) processes for all analysis and deliverables.
Required Skills & Qualifications:
- Bachelor’s degree in data science, Economics, Public Health, Finance, Business, or a related field (experience may be considered in lieu of degree).
- 4–6 years of experience in data analysis, healthcare analytics, or pricing within the healthcare industry (payer, PBM, or manufacturer experience preferred).
- Strong proficiency in Excel and SQL; experience with Power BI or similar visualization tools.
- Proficiency in data cleaning, manipulation, and analysis using Excel functions, formulas, and tools like PivotTables and charts
- Familiarity with healthcare claims data, pharmacy benefits, payer contracts, and group purchasing organizations (GPOs).
- Ability to interpret complex datasets and draw actionable insights for pricing and strategy.
- Strong attention to detail and commitment to data quality and compliance; familiarity with HIPAA and healthcare data privacy requirements being preferred.
- Excellent written and verbal communication skills; able to present data to both technical and non-technical audiences.
- Project management experience and ability to juggle multiple priorities in a fast-paced, evolving environment.
- Demonstrated success working in a remote or virtual work environment, including the ability to work independently, manage competing priorities, collaborate effectively across geographically dispersed teams, and maintain accountability with minimal supervision.
Preferred Qualifications:
- Experience working in mission-based organizations.
- Experience working within the bleeding disorders community, including Hemophilia Treatment Centers (HTCs), specialty pharmacy, patient advocacy organizations, manufacturers, payers, or other related stakeholders.
- Understanding of the 340B drug pricing program and alternative pricing models.
- Prior involvement in payer negotiations, rebate modeling, or specialty pharmacy analytics.
Working Conditions:
- Location: Remote office-based with required travel for meetings and events.
- Hours: Typically, 8am – 5pm, with occasional flexible hours for events and meetings.
- Physical Requirements: Ability to lift and carry up to 50 pounds.
Job Type: Full-time
Pay: $60,000.00 - $100,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Professional development assistance
- Vision insurance
Education:
Experience:
- remote-work: 2 years (Preferred)
Willingness to travel:
Work Location: Remote
