Manager Network Pricing - Remote in Cypress, CA

UnitedHealth Group • Cypress, CA

87d • $89,900 - $160,600 • Remote

About The Position

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. Can we all agree that the quality of health care is marching forward and upward with great momentum? Yes. But it's not just quality of care. The entire system is becoming more efficient and effective thanks to companies like UnitedHealth Group and people like you. Here's your opportunity to use your expertise in new ways as you strike the balance between health care costs and resources. Performing unit cost and contract valuation analysis, you'll ensure that healthcare contracts are priced accurately and fairly for all involved. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 5 leader. This position supports and validates Provider Network (physicians, hospitals, pharmacies, ancillary facilities, shared/full risk delegation, etc.) contracting and unit cost management activities through financial modeling, analysis of utilization, and reporting. Conducts unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies. Manages unit cost budgets, target setting, performance reporting, and associated financial models. This position will primarily support Southern California. This position is based in Cypress, CA but remote arrangement will be considered based on work experience. You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Requirements

• 8+ years of analytical experience in financial analysis, healthcare pricing, network pricing, healthcare economics or related discipline
• 5+ years of experience with provider payment methodologies and healthcare products
• 5+ years of experience in 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 in 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
• Expertise in financial impact analysis, risk management and data manipulation
• Expert level proficiency in MS Excel
• 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

Nice To Haves

• 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

Responsibilities

• Support network pricing strategies and tactics, in collaboration with local network field leaders and network managers
• Analyze financial impact of provider contracts (e.g., facility; physician; ancillary)
• 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
• Communicate results of financial impact and analysis to appropriate stakeholder groups (e.g., Network Management; Network Pricing leadership)
• Conduct financial and network pricing modeling, analysis and reporting
• Perform unit cost and contract valuation analysis in support of 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 contract
• Review competitive analysis to identify appropriate pricing rate for provider

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

What This Job Offers

• Industry: Insurance Carriers and Related Activities