Senior Pricing Manager - St. Louis, MO
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.
Consulting, guiding, directing, developing and presenting recommendations to stakeholders, proposal design, pricing approach, competitive strategy, comp modeling, projected outcomes & impacts and corrective action recommendations while ensuring adherence to policy & procedure requirements.
As applicable, approves pricing as established in the Corporate Authorization Matrix, Client Patient and Pricing Operations Pricing Policy documents. Leverages extensive understanding of competitor laboratory service providers, regional & national group purchasing agreements, corporate strategies and regional & national marketplace activities/conditions, State rules for FQHC and Medicaid Lowest of the Low. Conducts qualitative and quantitative analysis to inform business decisions and develop alternatives.
Ensure adherence to the following policies:
▪ Corporate Authorization Matrix
▪ Price Concession & Deal Strategy Policy
▪ Compliance Policies applicable to pricing, billing
▪ Client Patient Pricing Policy
▪ Pricing Policy
▪ TSO Policy
▪ IPA Pricing Policy
▪ Regional & National Group Purchasing Agreements
Responsibilities as applicable based on supported customer segments:
▪ Bid review and pricing approval for test pricing, test margin, test margin/req, contribution margin/gross margin (approval as delegated by Senior Pricing Director).
▪ Provide direction to Customer Solutions on bid initiation/pricing changes/account linkages/account set-up, Contract Administration for bid proposals/appropriate contract language, Billing & Pricing Infrastructure for bid proposals/ implementation.
▪ Provide pricing direction for mergers & acquisitions activity including identification of pricing process, tool development as needed, determination of proper pricing in compliance with Quest policies, guidance to Customer Solutions, Research/Health Plan teams, Commercial.
▪ Manage and/or support the annual CPI program. Provide insights to accounts and account groupings impacting inclusion in the program and ensure Commercial and Sales Support adhere to established deadlines for contract submissions and commercial insights on grouping and special handling of certain clients.
▪ Manage the Account Remediation program and look back process for the Region. Provided insights on accounts and recommend corrective actions as well as ensure adherence to established deadlines
▪ Manage the maintenance, update and support of non-standard systems (i.e. SYS) and tools (i.e. BAT pricing tool). Provide insights to Infrastructure team on standard tools (i.e. eaccount) operational concerns such as TSO threshold, cost of testing and list price issues as well as formula errors, etc.
▪ Manage the maintenance of region- specific fee schedules (GMW 13 East 10) and manage the quarterly profitability analysis of the accounts on these fee schedules.
▪ Provide pricing support for all system conversions. Participate on teams, provide data and analysis and assist with conversion to eaccount.
▪ Manage the development and evaluate patient special quote impacts on third party reimbursements and Lowest of Low states. Lead initiatives to reduce negative reimbursement impacts
▪ Manage the development of FQHC pricing and lab services donation options for client bill that comply with state specific requirements. Manage the development of patient special quotes for FQHC clients. Approve the use of slide scale for patient direct donations.
▪ Manage both the FQHC and IPA portfolio review process and recommend corrective actions for profitability issues.
▪ Manage the development of pricing for National accounts that use specific region/state developed pricing. Coordinate approvals of the recommended pricing.
▪ Coordinate pricing proposal development and gain approvals across regions for multi-region clients.
▪ Manage the development of RFP pricing response for bid proposal.
▪ Responsible for the development, management, implementation and execution of pricing projects and initiatives that improve revenue growth, reduce turnaround time and improve productivity.
▪ Lead and manage staff through day to day activities, manage TAT and provide appropriate coaching and development.
▪ Participate and help improve/maintain Employee Engagement scores.
▪ Provide Audit support as needed.
Requirements for the Manager Role:
▪ Bachelor’s Degree in Finance, Accounting or Business preferred
▪ MBA preferred
▪ Minimum of 5+ years of experience in financial analysis, revenue or pricing/profitability analysis
▪ Demonstrated creative thinking, problem solving and organization skills
▪ Strong Financial acumen and analytical capabilities
▪ Solid business judgement, strong critical thinking and analytical ability to create and determine recommendations and make decisions.
▪ Effective Framing and Influencing, able to articulate solutions and options and get buy in from key stakeholders
▪ Strong interpersonal skills, team-work oriented and ability to work successfully in a matrixed, highly collaborative and fast paced work environment
▪ Ability to work independently and drive projects from start to finish
▪ Effective communication both written and oral
▪ High energy level, self-driven and able to handle multiple projects and proposals simultaneously
▪ People leadership experience preferred
▪ Experience in medical, healthcare or clinical lab testing environments preferred
▪ Must pass applicable Quest Diagnostics Pricing tests
Key Competencies Critical for Success:
▪ Business/Financial Acumen
▪ Collaboration /Customer Focus
▪ Strategic/Critical Thinking
▪ Framing and Influencing
▪ Consulting, directing, guiding, designing 45%
▪ Review and Approvals of pricing proposals 20%
▪ Coaching, Development, training self and others 20%
▪ Lead/participate on projects and initiatives that increase revenue, reimbursements 15%