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Network Pricing Consultant - Remote
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 successful candidate consults and validates Provider Network (physicians, hospitals, ancillary facilities, etc.) contracting and unit cost management activities through financial modeling, analysis of utilization, and reporting. They will also conduct unit cost and contract valuation analysis in support of network provider rate negotiations and unit cost management strategies. Other duties include managing unit cost budgets, target setting, performance reporting, and being responsible for related financial models.
This position will primarily support the East Region markets and is likely to be a telecommute arrangement.
Challenge can often be its own reward. But why settle for just being challenged when you can also be nurtured, mentored, and supported in building an impact and fast paced career? With UnitedHealth Group you can have all of the above, every day. Here's your opportunity to combine expertise and compassion in new ways 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.
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, consulting and collaborating with local network field leaders and network managers
- Analyze financial impact of provider contracts (e.g., facility; physician; ancillary)
- Analyze payment appendices to provide options for various contracting approaches and methodologies
- Communicate results of financial impact and analysis to appropriate stakeholder groups (e.g., Network Management, Network Pricing leadership)
- Effectively summarize information while providing supporting data to a variety of audiences
- Conduct financial and network pricing modeling, analysis and reporting
- Peer review the analytical models of others
- Perform unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies
- Influence pricing strategies and rate development by highlighting opportunities for improvement or protecting favorable rate structures
- Strategize with network management to create optimal contracts
- Review competitive analysis to identify appropriate pricing rates for providers
- Perform various ad hoc projects in a timely and accurate manner
- Demonstrate a consultative, customer focused mindset
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:
- Undergraduate degree
- 5+ years of analytical experience in financial analysis, health care pricing, network management, health care economics or related discipline
- 3+ years of experience with provider payment methodologies and healthcare products
- 2+ years of experience in creating and using financial modeling tools, spreadsheets and information acquisition tools
Intermediate level of proficiency in performing financial impact analysis, risk management and data manipulation - Expert level proficiency in MS Excel
Preferred Qualifications:
- Undergraduate degree in Math, Statistics, Finance, Economics or related field of study
- 3+ years of experience with provider payment methodologies and healthcare products
- Experience with medical coding (CPT, MSDRG, REV, ICD-10, etc.)
- Knowledge of MS Access
- Knowledge of Commercial, Medicare, and Medicaid PPO and HMO revenue and expense, as well as delegation financial modeling
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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 to $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 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.
