Network Pricing Consultant

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 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.

OptumRx is looking for a curious, adaptable, and self-motivated analyst to be part of our Network Pricing team. This is an intermediate analytics role where you will learn the business fundamentals of drug pricing and client performance management, the underlying data flows, and the tools and systems used in this type of financial analysis. The person in this role will work with and have regular exposure to analysts and projects in our global data science and network pricing teams. In addition, solid communication skills are important as this role partners with other departments including Underwriting, Contracting, Account Management, Operations and Tech teams to innovative new product offerings and effectively oversee client and pharmacy performance.

Position Description:

Supports and validates Provider Network (physicians, hospitals, pharmacies, ancillary facilities, etc.) contracting and unit cost management activities through financial and network pricing modeling, analysis, and reporting. Conducts unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies. Manage unit cost budgets, target setting, performance reporting, and associated financial models

Primary Responsibilities:

• Support the development of new products or strategic initiatives aimed at reducing the total cost of care
• Represent Network Pricing in cross functional meetings (governance, strategy discussions, client implementations)
• Transforms data into meaningful and easy to understand insights for various audiences
• Create specifications to bring data into a common structure, create product specifications and models, developing data solutions to support data analysis
• Partner with stakeholders to understand data requirements and business needs and develop tools and models, and to assist building of dashboards and data visualizations
• Develop insights and proposals for improved business processes to enable speedy deployment and testing of future projects
• Build operational workflows, documentation and QA controls for repeatable and compliant pricing execution
• Product, service, or process decisions are most likely to impact multiple groups of employees and/or customers (internal or external)
• Lead and perform financial analysis and modeling as it relates to setting prescription drug prices
• Monitor pricing performance against financial targets, approve deviations, and adjust strategies as necessary.
• Perform data mining, claims research, and QA drilling down on drivers associated to client performance
• Prepare regular and ad hoc reports on pricing performance, financial outcomes, and client reporting
• Concisely summarize and communicate complex concepts, statistical findings and conclusions in ways that can be understood by a variety of audiences
• Translate and decipher contract language as it relates to client commitments and reconciliation
• Proactively identify and resolve issues
• Partner with other departments including Underwriting, Legal, Operations, and Account Management to effectively oversee client performance management
• Conduct or support market intelligence research for competitive drug costs, including supply chain, insured benefits, discount card (i.e. cash card), NADAC, and other reference points
• Enhance and utilize pricing trackers and tools to forecast trends and recommend adjustments for new product offering

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 analytical experience in financial analysis, healthcare pricing, network management, healthcare economics, or related discipline
• 2+ years of experience in creating and using financial modeling tools, spreadsheets, and information acquisition tools including experience in interpreting and/or displaying financial modeling results to inform actionable decisions
• Advanced proficiency in performing financial impact analysis, risk management, and data manipulation

Preferred Qualifications:

• Previous Healthcare or PBM experience
• Experience in product development or supporting new service offerings
• Proficiency in SQL, Python and/or Tableau
• Proven solid written and verbal communication skills

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 to $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 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.  

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