Director Healthcare Economics, West Region in Pacific or Mountain Time Zones

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 equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. 

In this role within UHC Healthcare Economics, you’ll be responsible for unit cost management of facility contracts, overall deal management for health systems including fee for service and capitated facility, physician, and ancillary services, and function as the market lead for the Southern California market. In addition, you’ll also be executing and managing advanced financial modeling and strategies and ensuring that integral information tools are up to date.

This role is office-based if you reside within commuting distance from Cypress, CA or will be remote within the West Region (Pacific or Mountain time zones) if you are outside of the Cypress, CA area.  

Primary Responsibilities:

• Develop and execute strategies for healthcare economics – FFS and delegated capitation unit cost management that spans multiple markets/sites
• Independently identify, investigate and communicate cost and utilization patterns for inefficiencies and potential opportunities in attributed member populations to help reduce overall total cost of care
• Provide consultative advice on use of medical cost and membership data as subject matter expert and interpret/summarize analytical findings
• Evaluate financial impacts of network configurations across hospital, ancillary and physician provider types
• Work with cross-functional teams across the organization to make strategic decisions supported by data
• Serve as subject matter expert on data, reporting and methodologies supporting our contracts and relationships
• Resolve business problems, as well as lead others to resolve business problems that affect multiple functions or disciplines
• Influence decisions about product, service or process decisions that will impact multiple functions and/or customer accounts (internal or external)
• This role will involve external meetings, and some travel, to negotiate with providers, share performance results and explain complex financial models

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
• 7+ years of analytical experience in financial analysis, health care pricing, network management, health care economics or related discipline
• 7+ years of experience with provider payment methodologies and health care products and expert level of proficiency in performing financial impact analysis, risk management and data manipulation
• 7+ years of experience in creating and using financial modeling tools, spreadsheets and information acquisition tools using financial modeling to evaluate the impact of contract changes and develop forecasts
• 5+ years of supervisory experience
• Highly proficient in Commercial, Medicare, and Medicaid FFS payment methodologies and contractual payment language for hospital and ancillary services
• Knowledgeable/experience with concepts of Medicare, Commercial, Medicaid and ACA risk adjustment, percent of premium contracting, and impacts on pricing
• Capable and experience with advanced statistical and financial modeling
• Expert level of proficiency in performing financial impact analysis, risk management, and claims data manipulation
• Expert level of proficiency in MS Excel and well versed in PowerPoint 
• Proven successful leadership and people management experience
• Proven solid written and verbal communication skills including negotiating and presenting
• Willing and able to travel 30% +/- depending on business need typically within the West US Region
• Reside in Pacific or Mountain time zones

Preferred Qualifications:

• Postgraduate degree
• 1+ years of experience working with large databases to produce a focused analysis with proficiency in SAS/SQL/R/Python for data manipulation and reporting
• Experience with Commercial, Medicare, and Medicaid PPO and HMO revenue, expense, P&L concepts, and capitated delegation financial modeling
• Beginner to moderate proficiency in Power BI, Tableau or other analytic visualization software

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

The salary range for this role is $150,200 to $288,500 annually based on full-time employment. 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.