Senior Healthcare Pricing Consultant

Job Location: 

This role is 100% remote.

Clearance:

Must be currently authorized to work in the United States on a full-time basis and have the ability to obtain a Public Trust Security Clearance. 

Job Description:

Blake Willson Group is seeking a Senior Healthcare Pricing Consultant to support the financial and price analysis of complex healthcare proposals for a major federal procurement. The consultant will apply hands-on experience in healthcare pricing, managed-care contracts, health-plan and TPA proposals, provider-network arrangements, and other complex service pricing to evaluate proposed prices, methodologies, assumptions, supporting data, and solicitation requirements. Working in coordination with a Senior Healthcare Actuarial & Acquisition Analytics Consultant, the consultant will translate pricing and acquisition analysis into clear, defensible findings supporting proposal evaluation, clarification development, negotiations, and source-selection activities. The ideal candidate will have recent federal proposal-evaluation and price-analysis experience, a strong pricing background, and sufficient healthcare knowledge to understand how healthcare assumptions affect proposed prices and integrate findings from actuarial and managed-care analytics specialists. In this position, you will also:

• Evaluate healthcare proposal pricing, cost models, rate structures, reimbursement approaches, administrative fees, discounts, utilization, trend, escalation, and other key cost drivers.
• Review solicitation requirements, evaluation criteria, contract terms, amendments, and other acquisition documentation to assess proposal and pricing conformance.
• Crosswalk Offeror pricing submissions against required structures, contract line items, periods, regions, populations, benefit categories, and supporting data.
• Validate pricing workbooks and models by reviewing formulas, calculations, reconciliations, assumptions, cross-references, and supporting documentation.
• Normalize and compare competing proposals using historical results, market benchmarks, Government data, independent estimates, and other available sources.
• Identify deficiencies, outliers, unsupported assumptions, inconsistencies, ambiguities, unbalanced pricing, and potential cost or performance risks.
• Develop clarification questions, evaluation findings, negotiation objectives, and fair-and-reasonable pricing recommendations, including potential financial impacts.
• Prepare Price Analysis Reports, comparison tables, executive briefings, decision-support materials, and traceable acquisition workpapers.
• Integrate findings from actuarial, healthcare analytics, and other technical specialists into overall pricing evaluations and negotiation recommendations.
• Update analyses through clarifications, discussions, proposal revisions, negotiations, and Final Proposal Revisions (FPRs) while maintaining procurement-sensitive information and meeting accelerated timelines.

Required Skills:

• Bachelor’s degree in Finance, Accounting, Economics, Business, Healthcare Administration, Mathematics, Statistics, or a related discipline.
• 7+ years of experience in pricing, financial analysis, contract pricing, healthcare pricing, acquisition, or a related field.
• 3+ years of experience evaluating healthcare pricing, reimbursement, provider/network pricing, or cost models for a federal agency, regulated purchaser, or advisory client, including hands-on pricing model analysis and validation.
• 3+ years of recent experience supporting federal Contracting Officers or source-selection teams with FAR Part 15 proposal evaluation, price analysis, negotiations, clarifications, discussions, revisions, FPRs, and acquisition documentation.

Desired Skills:

• Experience evaluating another organization's healthcare pricing, rates, reimbursement proposals, pricing models, or underlying assumptions for a purchaser, regulator, health plan, Government agency, or advisory client.
• Experience supporting federal or state healthcare procurements, proposal evaluations, negotiations, clarifications, discussions, FPRs, or other acquisition activities, preferably with knowledge of FAR Part 15 price analysis and acquisition documentation.
• Experience supporting large-scale healthcare programs, managed-care contracts, health-plan procurements, provider networks, TPAs, major health insurers, or programs such as VA/VHA, CMS, DHA/TRICARE, HHS, Medicare, Medicaid, VA Community Care, or FEHB.
• Experience evaluating medical and dental pricing, including provider reimbursement, claims, utilization, unit costs, network discounts, administrative fees, trend and escalation assumptions, regional adjustments, and value-based or risk-sharing arrangements.
• Experience analyzing healthcare data and building or validating complex pricing models using Excel, Power Query, Power BI, SQL, Python, R, or similar tools, and translating findings into pricing recommendations, acquisition decisions, or negotiation positions.
• Experience developing Price Analysis Reports, PNMs, pre-negotiation objectives, clarification questions, evaluation findings, fair-and-reasonable price determinations, or other acquisition documentation, with the ability to deliver accurate, traceable analyses under compressed timelines.

At Blake Willson Group, we believe in transparency and fairness in compensation practices. For this position, we offer a competitive salary range of $100,000 to $150,000 in the United States. Your individual salary within this range will be determined by various factors, including but not limited to your education, experience, skills, and geographic location. We also provide a comprehensive Total Rewards package, which includes major medical benefits such as dental and vision coverage, a 401(k)-contribution plan, holiday and personal time off, professional development training & certification benefits, health & wellness subsidies, paid time off for community service, and more. We value your contributions and are committed to recognizing and rewarding your performance and the value you bring to our business.