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.
You’ve been working your way to this opportunity for some time now.You are prepared to build an expertise in health care network operations. You’ve set your sights on having more impact in more ways. It’s time to join our team and help UnitedHealth Group as we help make the health system more efficient and effective. You’ll leverage your knowledge in new ways as you strike the balance between health care costs and resources. Joining a team responsible for performing unit cost and contract valuation analysis, you’ll ensure that health care contracts are priced accurately and appropriately. You will bring your skills as a team player who is able to work with large sets of data, executing a variety of projects while you gain actuarial training and healthcare economics experience.As you do, you’ll discover the resources, backing and opportunities that you’d expect from a Fortune 6 leader.
The Healthcare Economics Network Pricing Analyst supports and validates Provider Network (ACO’s, physicians, hospitals, pharmacies, ancillary facilities, etc.) contracting and unit cost management activities through financial modeling, analysis of utilization, and reporting. This position located in the Western US Region conducts unit cost and contract valuation analysis in support of medical provider negotiations and cost management strategies. Responsibilities also include managing unit cost budgets, target setting, performance reporting, and associated financial models.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Perform unit cost and contract valuation analysis and reporting in support of network contracting negotiations and unit cost management strategies
- Analyze financial impact of corporate initiatives (e.g., policy changes; healthcare affordability) or external regulations (e.g., healthcare reform)
- Analyze payment appendices to provide options for various contracting approaches and methodologies
- Strategize rates or contract methodology with network management to create optimal contract
- Evaluate financial impacts of network configurations across hospital, ancillary and physician provider types
- Communicate results of financial impact and analysis to appropriate stakeholder groups (e.g., Network Management; Network Pricing leadership)
- Review competitive analysis to identify appropriate pricing rate for provider
- Utilize appropriate tools (i.e., PPM, HPM, UCRT) to model and report impact of provider contracts
- Review charge master to ensure trending assumptions are correct
- Develop/maintain/update databases and tools needed to perform and support contract modeling
- Identify and investigate discrepancies (i.e., difference between actual allowed and modeled payment amount) in claim reimbursement
- Other duties as assigned by network pricing leadership
This role may involve some external meetings, and light 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:
- Bachelor’s degree or higher, preferably in Business, Health Administration, Computer Science, Engineering, MIS, Finance, Math
- Beginner level of proficiency in performing financial impact analysis, risk management, and claims data manipulation
- Moderate level proficiency in MS Excel
Preferred Qualifications:
- 1+ years of experience working with large databases to produce a focused analysis with proficiency in SAS/SQL for data manipulation and reporting
- Internship experience or other healthcare/financial experience and background
- Knowledge of Commercial, Medicare, and Medicaid payment methodologies for hospital, ancillary, and physician services
- Beginner or higher-level experience with SAS, SQL, or other relational database tools
- Knowledge of Commercial, Medicare, and Medicaid PPO and HMO revenue and expense, as well as delegation financial modeling
- Beginner to moderate proficiency in Power BI, Tableau or other analytic visualization software
- Experience with statistical functions for financial modeling
- Solid written and verbal communication skills
*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, or Washington Residents Only: The salary range for this role is $58,300 to $114,300 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with al 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.
SAS Verbal communication Data Analyst Tableau Financial Planner Databases Team player Big data Competition analysis SQL Written communication skills Microsoft Excel Power BI