We all can agree that the quality of health care is marching forward and upward with great momentum. But it's not just quality of care. The entire system is becoming more efficient and effective thanks to companies like UnitedHealth Group and people like you. Here's your opportunity to combine expertise and compassion in new ways as you strike the balance between health care costs and resources. In this role, you'll ensure that health care contracts are priced accurately and fairly for all involved. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 5 leader.
Primary Responsibilities:
- Analyze and re-price existing client claims data to support client specific data analytics using SQL server, Netezza databases
- Prepare requisite competitive (i.e., external) and internal historical claims data for use in the development of RFP response submission activities
- Utilize relational database tools to re-price/trial adjudicate pharmacy claims
- Validate source data and interpret/QA re-price/trial adjudication and summary and detail report results
- Analyze source historical claims data for anomalies and/or trends in drug utilization patterns and costs
- Develop and/or analyze and refine existing analytical models, and database queries as appropriate
- Conduct financial and network pricing modeling, analysis and reporting
- This opportunity is all about complexity. A dynamic marketplace means that unit cost forecasting will always be a challenge as costs continue to change. You'll be expected to monitor, analyze and incorporate those changes in reporting packages and relay them through finance to pricing and underwriting
- Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
Required Qualifications:
- Undergraduate degree or equivalent experience
- Analytical experience in data analysis
- Experience of writing complex SQL, PL/SQL queries for Data Analysis & Reconciliation
- Intermediate level of proficiency in MS Excel
- Intermediate SQL or other relational database solution experience
Preferred Qualifications:
- Analytical experience in data analysis, health care pricing, network management, healthcare economics or related discipline
- PBM experience
- Python, R for Analytical Model Development
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
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What We Do
Optum, part of the UnitedHealth Group family of businesses, is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.
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Optum Offices
Hybrid Workspace
Employees engage in a combination of remote and on-site work.
Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.
