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Optum

Network Pricing Consultant - Remote in CST/EST preferred

Posted 4 Hours Ago
Be an Early Applicant
Remote
Hiring Remotely in Ohio, USA
73K-130K Annually
Mid level
Remote
Hiring Remotely in Ohio, USA
73K-130K Annually
Mid level
Analyzes provider contracts, payment methodologies, unit costs, and financial impacts for healthcare network pricing. Develops financial models, forecasts, reports, and pricing strategies; supports negotiations, evaluates regulations and corporate initiatives, communicates findings to stakeholders, and leads complex analytical projects. Provides mentorship and peer review while managing budgets, targets, and performance reporting.
The summary above was generated by AI
Requisition Number: 2391779
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.
This opportunity is all about complexity and meaningful impact. You will play a key role in accurately and effectively pricing our provider network across East Region markets, including Kentucky, Indiana, and Ohio. Success in this role requires solid analytical thinking, creativity in interpreting contract structures, and the ability to leverage available resources to develop accurate and reliable pricing.
As a Network Pricing Consultant, you will support and validate Provider Network (hospital, physician, ancillary facilities, etc.) contracting and unit cost management activities through financial modeling, analysis, and reporting. You will conduct unit cost and contract valuation analysis to support negotiations and unit cost management strategies, while managing unit cost budgets, targets, and performance reporting.
Challenge can often be its own reward, but why settle for challenge alone when you can also be supported, mentored, and developed in a fast-paced and impactful career? With UnitedHealth Group, you can expect all of the above, every day. Here's your opportunity to combine analytical expertise and collaborative problem-solving 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, backed by the resources and stability of a Fortune 5 leader.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. 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
  • Evaluate financial impact of corporate initiatives and external regulations
  • Review payment appendices and develop options for various contracting approaches and methodologies
  • Communicate financial impact findings and insights to stakeholder groups
  • Conduct financial and network pricing modeling, analysis, and reporting
  • Provide mentorship and engage in detailed peer review activities
  • Perform unit cost and contract valuation analysis to support network contracting and unit cost management strategies
  • Lead large and complex analytical projects to support key business objectives
  • Influence pricing strategies and rate development by identifying opportunities or safeguarding favorable structures
  • Collaborate with Network Management to strategize rates or contract methodologies
  • Review competitive analysis to determine appropriate provider pricing

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:
  • 4+ years of analytical experience
  • 3+ years of experience with provider payment methodologies and healthcare products
  • Experience presenting to internal or external stakeholders
  • Demonstrated financial impact analysis and data manipulation skills
  • Demonstrated advanced proficiency in Microsoft Excel
  • Proven ability to interpret financial modeling results and develop forecasts
  • Proven ability to manage multiple projects simultaneously
  • Proven ability to research and solve problems independently

Preferred Qualifications:
  • Experience with advanced statistical functions for financial modeling
  • Experience with various payment methodology types
  • Demonstrated knowledge of commercial, Medicare, and Medicaid PPO/HMO revenue and expense patterns
  • Demonstrated solid interpersonal, collaboration, negotiation, and communication abilities

*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.
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 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.

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