Network Pricing Consultant - Remote

UnitedHealth Group • Full-time • Remote (Columbia, Maryland, United States) • 5d ago

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.