Pricing Analyst III

Job Overview

Modivcare is looking for an experienced Pricing Analyst III to join our team. As a Pricing Analyst III, you will play a key role in developing, maintaining, and enhancing pricing models, repricing analyses, and contract-level financial analytics that support Modivcare's Non‑Emergency Medical Transportation (NEMT) business. The role partners across Finance, Sales, Business Development, Operations, Network, Product, Revenue Cycle, and Client Management to evaluate pricing strategies, contract economics, profitability, and operational performance while delivering data‑driven recommendations that support new business, renewals, RFP responses, pricing events, and ongoing contract performance reviews.

• Develop, maintain, and enhance NEMT pricing models for new business opportunities, renewals, repricing events, RFP responses, and contract amendments.
• Analyze contract terms and conditions to identify pricing implications, financial risks, reimbursement mechanics, service obligations, and margin impacts.
• Collaborate with cross‑functional teams to develop pricing proposals and financial models for clients.
• Build and maintain account‑level and market‑level income statement views that compare original pricing assumptions to monthly, quarterly, and year‑to‑date actual results, monitoring contract performance to ensure pricing and performance alignment.
• Evaluate key financial and operational metrics by contract, market, and contract type.
• Support RFP pricing by translating operational requirements into financial assumptions, including staffing, transportation network needs, provider reimbursement, reporting requirements, implementation complexity, technology needs, service levels, and compliance obligations.
• Analyze pricing and profitability across various contract structures, including full‑risk, shared‑risk, fee‑for‑service, capitation, and ASO arrangements.
• Identify and evaluate cost drivers that impact pricing and margin performance.
• Conduct advanced analysis of large and complex data sets to identify trends, utilization anomalies, margin leakage, and pricing opportunities.
• Prepare pricing reports, variance analyses, executive summaries, dashboards, and presentations for senior management and cross‑functional stakeholders.
• Maintain accurate pricing databases, assumption libraries, model documentation, and data sources to support reporting, auditability, and repeatable processes.
• Partner with Network and Operations teams to understand provider capacity, local market dynamics, transportation supply constraints, rate adequacy, and fair market cost drivers while supporting "should cost" rate benchmarking.
• Collaborate with Revenue Cycle and Encounters teams to understand claims, denials, payment reconciliation, encounter submission, and revenue integrity impacts on contract economics.
• Recommend process improvements to optimize pricing workflows, data quality, model governance, reporting, and post‑award feedback loops.
• Stay current on NEMT, Medicaid, Medicare Advantage, managed care, healthcare transportation, regulatory requirements, and market dynamics that may influence pricing strategies.
• Perform other duties and may lead projects as assigned. This role does not have supervisory responsibilities.

• Bachelor's degree required, preferably in Finance, Accounting, Economics, Business Analytics, Data Analytics, Statistics, Mathematics, Healthcare Administration, or a related field.
• Five (5) or more years of experience in pricing, financial analysis, data analytics, FP&A, healthcare analytics, managed care analytics, transportation analytics, or a related field.
• Experience supporting RFPs, renewals, pricing events, contract repricing, financial modeling, or client proposals strongly preferred.
• Experience in Non‑Emergency Medical Transportation (NEMT), Medicaid, Medicare Advantage, managed care, healthcare services, transportation, logistics, or provider network operations preferred or equivalent combination of education and/or experience.
• Strong understanding of pricing strategies, methodologies, financial modeling, and profitability analysis.
• Strong financial acumen, including the…