Job Description

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 to start Caring. Connecting. Growing together.
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.
If you are located in the Pacific and Hawaii Time Zones, you will have the flexibility to work remotely* 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:

• Beginner level of proficiency in performing financial impact analysis, risk management, and claims data manipulation
• Moderate level proficiency in MS Excel
• Telecommute or office-based within West Region office locations (PST OR Hawaii)

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
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 $58,800 to $105,000 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 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.

Skills Required