Payer Pricing Analyst

Come join CCRM Fertility, a global pioneer in fertility treatment, research, science, specializing in IVF, fertility testing, egg freezing, preimplantation genetic testing, third party reproduction and egg donation. As a member of CCRM Fertility’s diverse team of professionals, you will be a part of helping families grow and changing lives. We take pride in providing our employees with meaningful employment, a supportive culture, and a well-balanced personal & work life alignment. For more information, visit www.ccrmivf.com

Location Address: 9380 Station St, Lone Tree, CO 80124

Department: Payer Strategy

Work Schedule: Hybrid - Monday – Friday (8:00am – 4:30pm)

What We Offer Our Team Members:

• Generous Paid time-off (PTO) and paid holidays
• Medical, Dental, and Vision Insurance
• Health benefits eligible the first day of the month following your start date.
• 401(k) Plan with Company Match (first of the month following 2 months of service)
• Basic & Supplement Life Insurance
• Employee Assistance Program (EAP)
• Short-Term Disability
• Flexible spending including Dependent Care and Commuter benefits.
• Health Savings Account
• CCRM Paid Family Medical Leave (eligible after 1 year)
• Supplemental Options (Critical Illness, Hospital Indemnity, Accident)
• Professional Development, Job Training, and Cross Training Opportunities
• Bonus Potential

What You Will Do: The Payer Pricing Analyst provides analysis of revenue, market share, capacity, and competitor activity to develop optimal pricing for geographies and market segments aligned with the CCRM strategy. This position conducts market research, assesses data, and develops insights into market trends, pricing strategies, and maintains historical pricing data to monitor and evaluate the effectiveness of pricing and guide pricing decisions. The Payer Pricing Analyst coordinates tools, reports, and communications for accurate pricing information responsive to market changes and reports directly to the Director of Payer Strategy.

• Develop and implement comprehensive payer strategies aligned with CCRM’s goals and market access objectives.
• Conduct in-depth analysis of payer trends, market dynamics, competitor pricing, and reimbursement strategies to identify opportunities/potential challenges.
• Build and maintain strong relationships with key payer stakeholders (i.e., payers, insurers, etc.).
• Design and execute reimbursement strategies to ensure optimal coverage and reimbursement for services and maximizing patient access.
• Generate evidence supporting the value proposition of CCRM’s offerings to support pricing and reimbursement discussions with payers.
• Ensure all payer-related activities are compliant with relevant healthcare regulations and policies.
• Partner with internal teams (marketing, finance, and legal) to align overall payer strategies.
• Monitor and evaluate the performance of payer contracts and reimbursement initiatives, making data-driven adjustments and improvements as needed.
• Stay up to date (monthly & quarterly) with healthcare industry trends, payer policies, and changes in reimbursement models which may impact revenue and influence future payer strategy decisions.
• Manages payer documentation, request fee schedule and exhibit updates, and monitor via tracker & calendar.
• Manages fee schedule uploads into billing software, assist with rate evaluation, and generate low payment reports and claims projects.
• Complete administrative tasks for managed care contract proposals and assist with monitoring and analyzing financial performance.
• Foster strong relations with commercial and alternative payers and create/maintain provider portal logins.
• Other duties as assigned.

What You Bring:

• Bachelor's degree in Business, Healthcare Administration, Marketing, or a related field required.
• 2 years’ experience in payer strategy, revenue cycle management, market access, managed care, women’s health, or related roles within the healthcare preferred.
• Experience in healthcare payer dynamics, reimbursement models, and health insurance landscape preferred.

Working Conditions: The physical demands described here are representative of those which should be met, with or without reasonable accommodation (IAW ADA Guidelines), by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to communicate with others, frequently required to sit at a desk, work on a computer, and spend prolonged periods preparing and analyzing data and figures. Will occasionally stand and/or walk; use hands and fingers to grasp, pick, pinch, type; and reach with hands and arms. Employees are required to have close visual acuity to perform an activity such as viewing a computer terminal; extensive reading; operation of standard office machines and equipment (computer, telephone, photocopier, and scanner).

Pre-Employment Requirements: All offers of employment are conditional upon the successful completion of the CCRM Fertility onboarding process, including verification of eligibility and authorization to work in the United States. This employer participates in the E-Verify Program in order to verify the identity and work authorization of all newly hired employees.

Equal Employment/Anti-Discrimination: We are an equal-opportunity employer. In all aspects of employment, including the decision to hire, promote, discipline, or discharge, the choice will be based on merit, competence, performance, and business needs. We do not discriminate on the basis of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law.