Fin Contract Supp- Sr Analyst- Secaucus, New Jersey in Secaucus, NJ at Quest Diagnostics

Date Posted: 2/20/2020

Job Snapshot

Job Description

Sr. Financial Analyst- Health Plan Finance

Secaucus, New Jersey - M - F


Look for more than answers. Patients and Physicians rely on our diagnostic testing, information and services to help them make better healthcare decisions. These are often serious decisions with far reaching consequences, and require sensitivity, tact and a clear dedication to service. It’s about providing clarity and hope. 
You will work for the world leader in the industry, with a career where you can
expand your skills and knowledge. You’ll have a role where you can act with
professionalism, you can inspire colleagues, and you can care about the work we do and the people we serve. 

At Quest, we are on a continuous journey of discovery and development. It’s this attitude that has made us an industry leader and the #1 Diagnostic Lab in the US. For those joining us, we offer exciting and fast moving career opportunities where you can affect change at a rate unheard of in many organizations of our size and scope. While we invest in and develop technology to drive our innovations, our ongoing success relies on our people.
Supports the financial and operational evaluation of prospective Health Plan contracts, providing consulting and recommendations to insure growth and profitability of third-party payors. Towards this goal, works closely with Health Plan Sales, Regional Finance and Health Plans Finance Contract Support Manager.  Partners with representatives of the Health Plan sales organization in response to contract proposals for regional and national contracts.


Job Accountabilities:
•   Performs all financial analyses required for prospective third-party contracts including the compilation of fee schedules, revenue projections, synergy analyses and “what-if” scenarios.
• Calculates specific CAP PMPM rates and develops CPT based fee schedules for key regional and national contracts.
• Develops utilization and membership corridors and integrates such corridors into contracts where applicable to protect the Company from downstream risk with capitated arrangements.
• Supports the development of standard premium priced tests, capitation carve-outs and overall pricing guidelines.
• Works closely with the Clinical Franchise department to ensure that pricing guidelines for high value and new test campaigns are considered in prospective contracts.
• Serves as a content expert to regional leadership regarding third party contracts and pricing strategies.
• Interfaces directly with regional leadership regarding the price, volume, and cost implications associated with new and existing third-party contracts.
• Develops methods to streamline the pricing review and authorization process for third-party contracts.
• Performs specific test campaign analyses to determine the prospective revenue and volume impact for key test initiatives.
• Partners with Billing function to review, disseminate, and recommend enhancements to third-party data used to build financial models.
• Supports the annual budget process providing details and insights on known and potential contract changes in the coming year.
• Ad-hoc projects as needed.


Qualifications:
-  Bachelor’s degree
-  A minimum of three years relevant financial analysis experience
-  Strong understanding of the healthcare industry and health plans specifically (product types, trends, etc.)
-  Strong financial and analytical skills
-  Innovative thinker comfortable with ambiguity to complete tasks
-  Ability to work effectively cross-functionally in a matrix environment and build/maintain relationships
-  Excellent verbal and written communication skills
-  Ability to work effectively both independently and within a team
-  Strong PC skills (Excel, Access, PowerPoint, Word)


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