Consultant, Healthcare Economics & Hospital Contracting Analytics
About The Position
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Senior Healthcare Economics Consultant (Network Pricing & Analytics) is responsible for supporting provider reimbursement analysis, pricing strategy support, financial modeling, and analytical reporting activities across provider network initiatives. This role oversees complex healthcare data analysis, dashboard development, reimbursement modeling, and cost trend analysis to support network contracting, operational performance, and enterprise cost management strategies. The Manager partners closely with contracting, clinical, finance, actuarial, operations, provider relations, and executive leadership teams to evaluate pricing impacts, support provider negotiations, and drive data-informed business decisions. This role also provides leadership and mentorship to analytical staff while advancing reporting automation, analytical capabilities, and operational efficiencies. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Requirements
- Bachelor’s degree in finance, Economics, Healthcare Administration, Business Analytics, Statistics, or related field
- 2 + years of experience in healthcare pricing, provider reimbursement, managed care analytics, healthcare finance, or network contracting
- 2 + years of experience leading projects, initiatives, or analytical teams
- 2 + years advanced proficiency in Microsoft Excel, SQL, and data analysis techniques
- Experience working with large healthcare claims datasets and relational database environments
- Experience developing dashboards and visual reporting using Tableau, or similar tools
- Demonstrated experience in financial modeling, trend analysis, and executive-level reporting
- Solid understanding of healthcare reimbursement methodologies including: Fee-for-service, Capitation, DRG, APC, Medicare-based reimbursement, Per Diem, Case Rates, Stop Loss and Percent of billed charges, Value-based payment methodologies
- California Hospital Market Knowledge
- Proven solid communication, organizational, and stakeholder management skills
- Proven ability to manage multiple priorities and lead cross-functional initiatives
Nice To Haves
- Master’s degree in business, Statistics, Healthcare Administration, Finance, Data Analytics, or related fields
- Experience within managed care, health insurance, PPO, or provider contracting organizations
- Experience with healthcare claims systems, contract modeling software, or reimbursement configuration platforms
- Experience using SQL, SAS, Python, R, Snowflake, Databricks, or advanced analytical platforms
- Experience leading reporting automation or analytical transformation initiatives
- Knowledge of CMS reimbursement methodologies and healthcare regulatory requirements
Responsibilities
- Lead provider reimbursement analysis, pricing model development, and financial impact assessments supporting network strategy initiatives
- Manage large healthcare datasets including medical claims, reimbursement, provider, utilization, and financial performance data
- Oversee development and optimization of SQL queries, analytical models, and automated reporting processes
- Design, develop, and maintain dashboards and executive reporting tools using Tableau, Power BI, or similar business intelligence platforms
- Monitor healthcare cost trends, reimbursement performance, utilization patterns, and market benchmarks to identify strategic risks and opportunities
- Support provider contract negotiations through financial modeling, pricing scenario analysis, and reimbursement benchmarking
- Ensure accuracy and integrity of pricing models, reimbursement logic, and analytical reporting deliverables
- Lead analytical initiatives focused on cost containment, network optimization, and operational performance improvement
- Collaborate with cross-functional stakeholders to prioritize analytical initiatives and deliver actionable business insights
- Oversee implementation and validation of fee schedule updates, reimbursement changes, and pricing configurations
- Mentor and develop analysts while promoting best practices in analytics, reporting, and process improvement
- Present analytical findings, strategic recommendations, and financial impacts to senior leadership and business partners
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Senior
