Executive - Healthcare Pricing - Provider

Job Summary

We are seeking a detail-oriented and analytical Healthcare Pricing Professional to manage provider pricing strategies, negotiate treatment packages with hospitals, and optimize healthcare costs while maintaining quality standards. The ideal candidate will have experience in health insurance, TPA, hospital networking, or healthcare operations with a strong understanding of hospital tariffs, claims trends, and provider relationship management.

Key Responsibilities

Pricing & Cost Management

• Develop, review, and implement pricing structures for medical procedures, hospital packages, and healthcare services.
• Analyze hospital tariffs, treatment costs, claims utilization patterns, and market benchmarks to determine competitive package rates.
• Conduct cost-benefit analysis to ensure pricing effectiveness and financial sustainability.
• Monitor pricing performance and recommend revisions based on utilization trends and business requirements.

Provider Network Management

• Identify, evaluate, and onboard hospitals to strengthen the healthcare provider network.
• Negotiate treatment package rates, discounts, and service-level agreements with hospitals.
• Build and maintain strong relationships with hospital stakeholders and decision-makers.

Data Analysis & Reporting

• Analyze healthcare market trends, competitor pricing, and provider performance metrics.
• Prepare pricing reports, negotiation summaries.
• Track package utilization, claims cost trends, and provider profitability indicators.
• Support decision-making through data-driven insights and recommendations.

Desired Qualifications

• MBA in Healthcare/Hospital Administration, Healthcare Management, Finance, or related field.
• Bachelor's degree in Healthcare, Life Sciences, Allied Health, or relevant discipline.

Experience

• 03 years of experience in Health Insurance, TPA, Hospital Networking, Provider Management, Medical Pricing, or Healthcare Operations.
• Experience in hospital empanelment, package negotiations, tariff analysis, or provider contracting preferred.

Key Skills

• Healthcare Pricing & Cost Analysis
• Hospital Package Negotiation
• Provider Network Management
• Medical Tariff Validation
• Data Analysis & Reporting
• Claims Cost Optimization
• Advanced Excel & MIS Reporting
• Communication & Negotiation Skills
• Market Research & Benchmarking
• Preferred Industry
• Health Insurance | TPA | Hospital Chains | Healthcare Consulting | Managed Care Organizations