UnitedHealthcare
Network Pricing Consultant - Remote
UnitedHealthcare, Cypress, California, United States, 90630
Network Pricing Consultant – Remote
UnitedHealthcare is simplifying the health‑care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts millions of lives for the better. Come help build the health‑care system of tomorrow—making it more responsive, affordable and optimized.
Responsibilities
Support network pricing strategies and tactics in collaboration with local field leaders and network managers.
Analyze the financial impact of provider contracts (facility, physician, ancillary).
Analyze the financial impact of corporate initiatives (policy changes, healthcare affordability) or external regulations (healthcare reform).
Analyze payment appendices to provide options for various contracting approaches and methodologies.
Communicate financial results and analysis to appropriate stakeholder groups (Network Management, Network Pricing leadership).
Conduct financial and network pricing modeling, analysis, and reporting.
Perform unit cost and contract valuation analysis to support network contracting negotiations and unit cost management strategies.
Lead large, complex projects to achieve key business objectives.
Influence pricing strategies and rate development by highlighting opportunities for improvement or protecting favorable rate structures.
Strategize rates or contract methodology with network management to create optimal contracts.
Review competitive analysis to identify appropriate pricing rates for providers.
Required Qualifications
4+ years of analytical experience in financial analysis, healthcare pricing, network pricing, healthcare economics, or related discipline.
3+ years of experience with provider payment methodologies and healthcare products.
3+ years of experience creating and using financial modeling tools, spreadsheets, and information acquisition tools.
Experience with provider capitation, both diagnostic risk‑adjustment and age/sex–adjusted rate banding.
Experience interpreting and reviewing financial modeling results to evaluate the financial impact of contract changes and develop forecasts.
Presentation experience to internal or external stakeholders or customers.
Expert level proficiency in MS Excel.
Proven expertise in financial impact analysis, risk management, and data manipulation.
Proven solid interpersonal, collaboration, negotiation, and communication skills.
Proven excellent communication skills, both written and verbal.
Proven ability to manage multiple projects simultaneously and meet deliverable deadlines.
Proven ability to research and solve problems independently.
Preferred Qualifications
Postgraduate degree in Mathematics, Statistics, Finance, Economics, or Actuarial Science.
Experience in MS Access, SAS, SQL, R, or Python.
Experience with advanced statistical functions for financial modeling.
Experience with medical coding (CPT, MSDRG, REV, ICD‑10, etc.).
Knowledge of Commercial, Medicare, and Medicaid PPO and HMO revenue and expense, as well as delegation financial modeling.
All employees working remotely must 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. The salary for this role will range from $71,200 to $127,200 annually for full‑time employment. In addition to your salary, we offer a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution (all benefits are subject to eligibility requirements). We comply with all minimum wage laws as applicable.
Application Deadline:
This posting will remain open for a minimum of two business days or until a sufficient candidate pool has been collected. The posting may end early due to the 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. We are committed to mitigating our impact on the environment and delivering equitable care that addresses health disparities and improves health outcomes.
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, 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.
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UnitedHealthcare is simplifying the health‑care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts millions of lives for the better. Come help build the health‑care system of tomorrow—making it more responsive, affordable and optimized.
Responsibilities
Support network pricing strategies and tactics in collaboration with local field leaders and network managers.
Analyze the financial impact of provider contracts (facility, physician, ancillary).
Analyze the financial impact of corporate initiatives (policy changes, healthcare affordability) or external regulations (healthcare reform).
Analyze payment appendices to provide options for various contracting approaches and methodologies.
Communicate financial results and analysis to appropriate stakeholder groups (Network Management, Network Pricing leadership).
Conduct financial and network pricing modeling, analysis, and reporting.
Perform unit cost and contract valuation analysis to support network contracting negotiations and unit cost management strategies.
Lead large, complex projects to achieve key business objectives.
Influence pricing strategies and rate development by highlighting opportunities for improvement or protecting favorable rate structures.
Strategize rates or contract methodology with network management to create optimal contracts.
Review competitive analysis to identify appropriate pricing rates for providers.
Required Qualifications
4+ years of analytical experience in financial analysis, healthcare pricing, network pricing, healthcare economics, or related discipline.
3+ years of experience with provider payment methodologies and healthcare products.
3+ years of experience creating and using financial modeling tools, spreadsheets, and information acquisition tools.
Experience with provider capitation, both diagnostic risk‑adjustment and age/sex–adjusted rate banding.
Experience interpreting and reviewing financial modeling results to evaluate the financial impact of contract changes and develop forecasts.
Presentation experience to internal or external stakeholders or customers.
Expert level proficiency in MS Excel.
Proven expertise in financial impact analysis, risk management, and data manipulation.
Proven solid interpersonal, collaboration, negotiation, and communication skills.
Proven excellent communication skills, both written and verbal.
Proven ability to manage multiple projects simultaneously and meet deliverable deadlines.
Proven ability to research and solve problems independently.
Preferred Qualifications
Postgraduate degree in Mathematics, Statistics, Finance, Economics, or Actuarial Science.
Experience in MS Access, SAS, SQL, R, or Python.
Experience with advanced statistical functions for financial modeling.
Experience with medical coding (CPT, MSDRG, REV, ICD‑10, etc.).
Knowledge of Commercial, Medicare, and Medicaid PPO and HMO revenue and expense, as well as delegation financial modeling.
All employees working remotely must 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. The salary for this role will range from $71,200 to $127,200 annually for full‑time employment. In addition to your salary, we offer a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution (all benefits are subject to eligibility requirements). We comply with all minimum wage laws as applicable.
Application Deadline:
This posting will remain open for a minimum of two business days or until a sufficient candidate pool has been collected. The posting may end early due to the 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. We are committed to mitigating our impact on the environment and delivering equitable care that addresses health disparities and improves health outcomes.
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, 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.
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