Network Pricing Consultant - Remote

Join UnitedHealthcare

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. 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.

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, …