Network Pricing Consultant - Remote

Posted Yesterday
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Hiring Remotely in Columbia, MD, USA
In-Office or Remote
73K-130K Annually
Mid level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Supports provider network pricing and contracting through financial modeling, utilization analysis, contract valuation, unit-cost management, forecasting, and reporting. Evaluates financial impacts of provider contract changes, reviews payment methodologies, develops pricing recommendations, peer-reviews analytical models, and communicates findings to network management and leadership. The role also supports negotiations, budget and target setting, competitive pricing analysis, and related projects.
Summary Generated by Built In
Requisition Number: 2391346
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities andremoving barriers to quality care. The work you do here impacts the lives of millions of people for thebetter. Come build the health care system of tomorrow, making it more responsive, affordable andoptimized. Ready to make a difference? Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.
The successful candidate supports and validates Provider Network (physicians, hospitals, pharmacies, ancillary facilities, etc.) contracting and unit cost management activities through financial modeling, analysis of utilization, and reporting. They will also conduct unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies. Other duties include managing unit cost budgets, target setting, performance reporting, and being responsible for related financial models.
This position will primarily support the East Region markets and is likely to be a telecommute arrangement.
Challenge can often be its own reward. But why settle for just being challenged when you can also be nurtured, mentored, and supported in building an impact and fast paced career? With UnitedHealth Group you can have all of the above, every day. 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.
If you are located in EST and CST working hours, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
  • Support network pricing strategies and tactics, in collaboration with local network field leaders and network managers
  • Analyze financial impact of provider contracts (e.g., facility; physician; ancillary)
  • Analyze payment appendices to provide options for various contracting approaches and methodologies
  • Communicate results of financial impact and analysis to appropriate stakeholder groups (e.g., Network Management, Network Pricing leadership)
  • Effectively summarize information while providing supporting data to a variety of audiences
  • Conduct financial and network pricing modeling, analysis and reporting
  • Peer review the analytical models of others
  • Perform unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies
  • Influence pricing strategies and rate development by highlighting opportunities for improvement or protecting favorable rate structures
  • Strategize with network management to create optimal contracts
  • Review competitive analysis to identify appropriate pricing rates for providers
  • Perform various ad hoc projects in a timely and accurate manner
  • Demonstrate a customer service mindset

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Please review the required qualifications as posted below. You must meet or exceed the requirements posted to be eligible for review for the position.
Required Qualifications:
  • Undergraduate degree in Math, Statistics, Finance, Economics or related field of study
  • 4+ years of analytical experience in financial analysis, healthcare pricing, network pricing, healthcare economics or related discipline
    Presentation experience to internal or external stakeholders or customers
  • Familiarity with interpreting and reviewing financial modeling results to evaluate the financial impact of contract changes and developing forecasts
  • Advanced level of proficiency in Microsoft Excel
  • Proven excellent financial impact analysis, risk management, and data manipulation skills
  • Proven excellent interpersonal, collaboration, negotiation, and communication skills
  • Proven ability to manage multiple projects simultaneously and meet deliverable deadlines
  • Proven ability to research and solve problems independently

Preferred Qualifications:
  • Postgraduate degree in Math, Statistics, Finance, Economics or Actuarial Science
  • 3+ years of experience with provider payment methodologies and healthcare products
  • Experience with MS Access, SAS and/or SQL
  • Experience with advanced statistical functions for financial modeling
  • Experience with medical coding (CPT, MSDRG, REV, ICD-10, etc.)
  • Knowledge of Commercial, Medicare, and Medicaid PPO and HMO revenue and expense, as well as delegation financial modeling

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.
UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Skills Required

  • Undergraduate degree in Math, Statistics, Finance, Economics, or a related field
  • 4+ years of analytical experience in financial analysis, healthcare pricing, network pricing, healthcare economics, or a related discipline
  • Presentation experience with internal or external stakeholders or customers
  • Familiarity with interpreting financial modeling results, evaluating contract-change impacts, and developing forecasts
  • Advanced proficiency in Microsoft Excel
  • Financial impact analysis, risk management, and data manipulation skills
  • Excellent interpersonal, collaboration, negotiation, and communication skills
  • Ability to manage multiple projects and meet deliverable deadlines
  • Ability to research and solve problems independently
  • Postgraduate degree in Math, Statistics, Finance, Economics, or Actuarial Science
  • 3+ years of experience with provider payment methodologies and healthcare products
  • Experience with MS Access, SAS, and/or SQL
  • Experience with advanced statistical functions for financial modeling
  • Experience with medical coding, including CPT, MSDRG, REV, or ICD-10
  • Knowledge of Commercial, Medicare, and Medicaid PPO and HMO revenue and expense, and delegation financial modeling

What the Team is Saying

Optum Compensation & Benefits Highlights

  • Leave & Time Off Breadth — PTO is generally described as decent or good, and many note it as a strong part of the package. Actual ability to take time off can depend on workload and team coverage.
  • Retirement Support — Offerings include a 401(k) with employer match and access to an employee stock purchase plan, which are highlighted as meaningful components of total rewards. These programs are consistently referenced among core benefits.
  • Parental & Family Support — Parental and caregiver leave, along with adoption assistance, are publicly highlighted and viewed as notable elements of the package. Availability can be role-specific, but these supports contribute to overall breadth where offered.

Optum Insights

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The Company
HQ: Eden Prairie, MN
160,000 Employees
Year Founded: 2011

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.

Typical time on-site: Not Specified
HQEden Prairie, MN
Metro Manila, Philippines
Cebu, Philippines
Davao, Philippines
Ann Arbor, MI
Atlanta, GA
Baltimore, MD
Bengaluru, India
Chennai, India
Dallas, TX
Detroit, MI
Dublin, Ireland
Hartford, CT
Houston, TX
Hyderabad, India
Jacksonville, FL
Las Vegas, NV
Letterkenny, Ireland
Louisville, KY
Madison, WI
Minneapolis, MN
Nashville, TN
New Delhi, India
Philadelphia, PA
Phoenix, AZ
Pune, India
Raleigh, NC
San Diego, CA
Washington, DC
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