Senior Network Pricing Consultant

UnitedHealth Group•Eden Prairie, MN

4d•$60,200 - $107,400•Remote

About The Position

A Senior Network Pricing Consultant focuses on analyzing and repricing of pharmacy claims to ensure accurate cost management. This role will work on pricing applications and projects related to the manipulation and analysis of data in support of a variety of analytic solutions. You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.

Requirements

Ability to analyze complex data and identify trends and discrepancies
Ensure accuracy in all aspects of claim analysis and pricing adjustments
Communicate clearly and effectively with team members and stakeholders
Understanding of PBM processes, regulations, and industry standards
Strong skills in SQL and relational database tools
Bachelor's degree
2+ years of analytical experience in financial analysis, PBM healthcare pricing, Network pricing or related discipline
2+ years of experience with SQL Server or other relational database solutions
2+ years of experience in writing Complex SQL/PLSQL queries for data analysis and reconciliation
2+ years of Analytical experience in data analysis
Advanced level of proficiency in MS Excel

Nice To Haves

PBM Experience
SQL Server Azure experience
Technical writing skills

Responsibilities

Analyze and re-price existing client claims data to support client-specific data analytics using SQL server database
Prepare competitive external and internal historical claims data for use in the development of RFP response submission activities
Use relational database tools to re-price/trial adjudicate pharmacy claims
Validate source data and interpret re-price/QA/trial adjudication and summary and detail report results
Analyze source historical claims data for anomalies and/or trends in drug utilization patterns and costs
Develop and/or analyze and refine existing analytical models and database queries as appropriate
Conduct financial and network pricing modeling, analysis, and reporting
Work closely with internal teams, including finance, Accounting, and Sales, to ensure accurate and efficient claim processing
Keep detailed records of all pricing adjustments and ensure compliance with all relevant regulations and policies