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 Subject Matter Expert (SME) to evaluate complex managed healthcare pricing proposals for a major federal procurement valued at nearly $1 trillion. The role will analyze pricing, reimbursement methodologies, assumptions, and supporting data; identify financial risks and inconsistencies; and develop price analysis and negotiation recommendations. Candidates should have strong managed healthcare pricing experience and advanced Excel and financial analysis skills. In this position, you will also:

• Lead financial and price analysis of complex managed healthcare proposals valued at nearly $1 trillion.
• Review solicitation requirements, evaluation criteria, contract terms, amendments, and Government guidance to assess proposal compliance.
• Crosswalk Offeror pricing submissions against required structures, contract line items, periods, regions, benefit categories, and supporting data.
• Analyze rates, unit prices, administrative fees, discounts, reimbursement methodologies, escalation factors, trend assumptions, staffing costs, and other key cost drivers.
• Validate pricing workbooks by reviewing formulas, calculations, reconciliations, cross-references, and supporting documentation.
• Normalize and compare competing proposals using independent estimates, historical results, market benchmarks, Government data, and other Offeror submissions.
• Identify deficiencies, outliers, unsupported assumptions, inconsistencies, ambiguities, unbalanced pricing, and potential cost or performance risks.
• Develop clarification questions and evidence-based negotiation recommendations, including proposed positions and potential financial impacts.
• Prepare Price Analysis Reports, executive briefings, comparison tables, decision-support materials, and traceable source-selection workpapers; incorporate actuarial findings as appropriate.
• Update analyses through clarifications, proposal revisions, negotiations, and Government direction while maintaining procurement-sensitive information and meeting accelerated timelines.

Required Skills:

• Bachelor's degree in Finance, Accounting, Economics, Mathematics, Actuarial Science, Business, Statistics, Healthcare Analytics, or a related field.
• 8+ years of experience in progressively responsible pricing, financial analysis, proposal evaluation, healthcare economics, or related analytical work.
• 6+ years of experience analyzing managed healthcare pricing, including provider reimbursement, network discounts, claims pricing, administrative fees, utilization, trend assumptions, or risk-sharing arrangements.
• 6+ years of experience analyzing complex proposals and developing defensible financial conclusions, with advanced Excel, financial modeling, reconciliation, and technical-writing skills.

Desired Skills:

• Experience supporting federal proposal evaluations, negotiated acquisitions, and price analysis.
• Knowledge of FAR Part 15, including price analysis, proposal evaluation, clarifications, discussions, final proposal revisions, and negotiation documentation.
• Experience preparing price analysis reports, negotiation memoranda, evaluation findings, or similar acquisition documentation.
• Experience analyzing large-scale government healthcare programs, health-plan procurements, managed-care contracts, or provider networks, including Medicare, Medicaid, TRICARE, VA Community Care, or FEHB.
• Experience working with healthcare claims, encounter, eligibility, provider, utilization, and reimbursement data and analytical tools such as Power Query, Power BI, SQL, Python, or R.
• Relevant professional certification such as CPCM, CFCM, CCEA, CPA, CMA, CFA, or comparable credential.

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.

The statements above describe the general nature and level of work anticipated for this role. They are not intended to be an exhaustive list of all duties, responsibilities, or skills required. Blake Willson Group reserves the right to modify, assign, or add job-related responsibilities as business needs require. Where feasible, reasonable accommodations may be provided for individuals to perform essential job functions.