Model Validation Remote Jobs in Oregon (NOW HIRING)

Manager, Strategic Pricing and Analytics, Health Plan Relations

Remote

Company Overview: AMSURG is an independent leader in ambulatory surgery center services, operating a network of more than 250 surgery centers nationwide. In partnership with physicians and health systems, the organization delivers high-quality care for patients across a diverse spectrum of medical specialties, including gastroenterology, ophthalmology and orthopedics. To learn more about AMSURG, visit www.amsurg.com.

POSITION SUMMARY:

The Manager, Strategic Pricing & Analytics is responsible for overseeing the development of models and financial analyses of proposed contract rates for payer negotiations. The position will report to the Senior Director, Strategic Pricing & Analytics and work closely with the managed care contractors and cross-functional internal departments to model health plan proposals and other contract language. This role may supervise Analyst resource(s).

Work Schedule: Remote

ESSENTIAL RESPONSIBILITIES:

• Serve as a strategic partner to the Health Plan Relations (HPR) Contracting team, delivering advanced payer contract modeling and analytical support across all markets and center types.
• Lead modeling and analysis of current and proposed payer contract rates, interpreting outputs and price transparency to deliver actionable insights and strategic recommendations that inform HPR leadership decisions and optimize payer negotiation outcomes.
• Assess, compile, and synthesize price transparency data to support payer negotiations, including development of clear, executive-ready analyses and presentations as needed.
• Establish and enforce quality controls to ensure accuracy, consistency, and integrity of modeling outputs.
• Manage the biannual data request process, overseeing end-to-end data collection, validation, and cleanup to ensure accuracy and readiness for analysis.
• Proactively identify and resolve data inconsistencies, gaps, and limitations within billing data, working closely with Revenue Cycle Management and Operations to investigate and correct root-cause issues impacting data integrity.
• Oversee the execution of ad-hoc reimbursement analyses or other custom analytics as requested by leadership to drive strategic decision making.

QUALIFICATIONS: 

To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily.  The requirements listed below are representative of the knowledge, skills and/or abilities required.

• Expertise in healthcare industry, managed care contracts, reimbursement methodologies, and pricing strategies.
• Track record of strong critical thinking and problem-solving ability.
• Advanced Excel skills required.
• Fluency in Microsoft 365 applications, including Teams, SharePoint, and OneDrive.
• Basic, working knowledge of SQL preferred.
• Ability to understand, leverage, and audit pre-existing, complex Excel-based financial models, analyze large data sets, and translate insights into targeted, results-driven actions.
• Demonstrated ability to effectively communicate with C-suite and executive leadership (i.e., packaging and presenting nuanced and detailed information, fielding and responding to questions across the organization, etc.).

Core Competencies and Professional Attributes:

• Highly detail-oriented and organized, with strong follow-through and execution skills.
• Proven ability to manage and prioritize multiple tasks in a fast-paced, dynamic environment.
• Maintains the highest standards of integrity, including strict confidentiality of sensitive information.
• Collaborative, dependable team player with strong interpersonal skills and a positive demeanor.
• Must be able to exercise good judgment and positively influence and lead others.
• Self-directed with a strong sense of ownership and bias toward action.
• Effectively handles conflict in a constructive, respectful, and professional manner.
• Flexible and adaptable; willingness and ability to travel to the AMSURG corporate office as needed.

Education/Experience:

• Bachelor’s degree required, preferably in Finance, Accounting, Healthcare Administration, or a related field.
• 4–7 years of progressive experience in healthcare analytics, with a minimum of 2 years payer contract modeling experience.
• Demonstrated expertise in healthcare reimbursement methodologies (e.g., percent of CMS, proprietary fee schedules, groupers, carve-outs, percent of billed charges) and their application in contract modeling.
• Experience working with data from various billing platforms (e.g., HST, gPM, AdvantX, Insight/NextGen, SIS).

Employment at AMSURG: Living Our Values Every Day

At AMSURG, our values define who we are and how we serve our patients, partners, and each other. As a national leader in ambulatory surgery, we are committed to a culture of excellence, integrity, teamwork and caring deeply. Our values guide every decision, ensuring we continue to elevate healthcare and provide the highest quality care.
These guiding principles are the foundation of our culture and a guide to how we collaborate, innovate, and make a difference every day.

• Care Deeply for those around us.
• Cultivate Integrity to build trust.
• Champion Excellence for continuous improvement
• Celebrate Teamwork every step to the way.

Benefits:

To ensure we retain and invest in great people, AMSURG provides its employees with the benefits, recognition, training, and opportunities needed for professional growth. Our wide range of health and welfare benefits allow you to choose the right coverage for you and your family. AMSURG offers a variety of health and welfare benefit options to help protect your health and promote your wellbeing. Benefits offered include but are not limited to: Paid Time Off, Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA, Limited Healthcare FSA, FSAs for Transportation and Parking & HSAs, and a matching 401(K) Plan.

Paid Time Off:

AMSURG offers paid time off, 9 observed holidays, and paid family leave. You accrue Paid Time Off (PTO) each pay period and depending on your position and can earn a minimum of 20 days and up to 25 days per calendar year.

EOE Statement:

AMSURG is an Equal Opportunity Employer (EOE). Qualified applicants are considered for employment without regard to age (40 or older), race, color, religion, gender, sex, national origin, pregnancy, sexual orientation, disability, genetic information or any other status protected under applicable federal, state, or local laws. We strive to also provide a disability inclusive application and interview process. If you are a candidate with a disability and require reasonable accommodation in order to submit an application, please contact us at: careers@amsurg.com. Please include your full name, the role you’re applying for and the accommodation necessary to assist you with the recruiting process. 

#LI-CH1

#LI-REMOTE