Sr Healthcare Economics Consultant, Network Pricing – Remote

Optum 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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

This role within Optum Health’s Healthcare Economics Network Strategy & Analytics Department.  Candidate is responsible for producing their own quality work product, but also supports the design & development of new standard work products, refined processes for scaling analytics across markets, and overall data organization that supports our business goals. Candidate should have solid verbal skills, solid written communication skills and demonstrate self-motivation, initiative, and adaptability in a fast-paced environment.

This role primarily supports and validates provider and payor network contracting and trend management activities through financial or pricing modeling, negotiation support, analysis, and reporting. The team and this role manage unit cost budgets, reimbursement benchmarking, target setting, performance reporting, maintenance of associated financial models, and other responsibilities as assigned.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. 

Primary Responsibilities: 

• Design and implement sound tools utilizing programming languages, Tableau or other resources to identify principal health care cost and revenue drivers, by market segment and/or by provider/payor, referral patterns, and reimbursement rates
• Develop, evaluate, and provide consultative analytics to support negotiations for value-based arrangements, provider incentives, and fee-for-service contracts (hospital, physician, and ancillary)
• Evaluate financial impacts of network configurations across hospital, ancillary and physician provider types
• Determine credibility and usability of data prior to delivery of analytic results
• Build solid relationships within the organization including financial, actuarial, local market contracting, network contracting, and clinical operations areas

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: 

• 5+ years of professional experience, of which 3+ years focused healthcare analytics
• Experience modeling/pricing of large sets of raw medical claims data
• Intermediate or greater proficiency in MS-SQL (utilize and edit existing queries, create new queries, including joins and case statements)
• Advanced proficiency in Excel including advanced formulas and pivots

Preferred Qualifications:  

• Experience creating and editing Tableau work product
• Experience with CMS and Commercial fee for service reimbursement methodologies

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy 

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, or Washington, D.C. Residents Only: The salary range for this role is $88,000 to $173,200 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.   

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. 

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.