Senior Healthcare Economic Consultant - Remote

UnitedHealth Group•Austin, TX

18h•$91,700 - $163,700•Remote

About The Position

This role within Optum Health’s Healthcare Economics Network Strategy & Analytics Department is responsible for producing quality work products, supporting the design and development of new standard work products, refining processes for scaling analytics across markets, and overall data organization that supports business goals. Candidates should have strong verbal and written communication skills and demonstrate self-motivation, initiative, and adaptability in a dynamic environment. This role primarily supports and validates provider and payor network contracting and trend management activities through financial or pricing modeling, negotiation support, analysis, and reporting. The team and this role manage unit cost budgets, reimbursement benchmarking, target setting, performance reporting, maintenance of associated financial models, and other responsibilities as assigned. This role will partner closely with contracting, finance, actuarial, operations, provider relations, and executive leadership teams to evaluate pricing impacts, support provider negotiations, and drive data-informed business decisions. 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. Positions in this function research and investigate key business problems through quantitative analyses of utilization and healthcare costs data. Provides management with statistical findings and conclusions. Identifies potential areas for medical cost improvements and alternative pricing strategies. Provides data in support of actuarial, financial and utilization analyses. Reviews the work of others, develops innovative approaches, is sought out as an expert, and serves as a leader/mentor. 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.

Requirements

Undergraduate degree or equivalent experience
3+ years of analytical experience in healthcare pricing, managed care, provider reimbursement, network contracting, finance, or healthcare analytics
Experience working with healthcare claims and reimbursement methodologies
Advanced proficiency in Microsoft Excel, including pivot tables, formulas, and financial modeling
Intermediate or greater proficiency in MS-SQL (utilize and edit existing queries, create new queries, including joins and case statements)
Knowledge of Provider payment methodologies including: Risk Continuum Model - Fee-for-service, Capitation, Value-based and incentive payment models, Medicare, Commercial and Medicaid-based reimbursement
Proven solid attention to detail and ability to manage multiple priorities
Proven solid analytical and quantitative problem-solving skills
Proven effective written and verbal communication skills
Proven ability to work collaboratively across cross-functional teams

Nice To Haves

Bachelor’s degree in Finance, Healthcare Administration, Economics, Statistics, Mathematics, Business Analytics, or related field
Experience in managed care, health insurance, PPO networks, or provider contracting environments
Experience with claims systems, contract modeling software, or reimbursement configuration platforms
Knowledge of CMS reimbursement methodologies and regulatory guidelines
Familiarity with actuarial or healthcare financial analysis concepts

Responsibilities

Design and implement sound tools utilizing programming languages, BI tools, and other resources to identify principal health care cost and revenue drivers, by market segment and/or by provider/payor, referral patterns, and reimbursement rates
Involved with the development of SQL queries, analytical models, dashboards, and automated reporting tools to support executive decision-making
Analyze provider reimbursement analysis, pricing model development, and financial impact assessments to support network strategy and contract negotiations
Manage unit cost tracking and UCRT entries, ensuring alignment with anticipated negotiation outcomes and reimbursement changes
Analyze large healthcare datasets and monitor cost, utilization, reimbursement, and market trends to identify risks and opportunities
Ensure pricing, reimbursement, and reporting methodologies are accurate, consistent, statistically sound, and transparent
Support initiatives focused on cost containment, network optimization, and operational performance improvement in collaboration with cross-functional stakeholders
Present analytical findings and strategic recommendations to leadership and build strong partnerships across contracting, finance, actuarial, and market teams
Standardize and document repeatable processes to promote best practices and scalability.