Senior Provider Network Pricing Analyst - Remote for Pacific / Hawaii Time Zones

UnitedHealth Group Inc.•Cypress, CA

42d•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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Healthcare Economics Network Pricing Analyst supports and validates Provider Network (ACO's, physicians, hospitals, pharmacies, ancillary facilities, etc.) contracting and unit cost management activities through financial modeling, analysis of utilization, and reporting. This position located in the Western US Region conducts unit cost and contract valuation analysis in support of medical provider negotiations and cost management strategies. Responsibilities also include managing unit cost budgets, target setting, performance reporting, and associated financial models. If you are located in the Pacific and Hawaii Time Zones, you will have the flexibility to work remotely as you take on some tough challenges. 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

Beginner level of proficiency in performing financial impact analysis, risk management, and claims data manipulation
Moderate level proficiency in MS Excel
Telecommute or office-based within West Region office locations (PST OR Hawaii)

Nice To Haves

1+ years of experience working with large databases to produce a focused analysis with proficiency in SAS/SQL for data manipulation and reporting
Internship experience or other healthcare/financial experience and background
Knowledge of Commercial, Medicare, and Medicaid payment methodologies for hospital, ancillary, and physician services
Beginner or higher level experience with SAS, SQL, or other relational database tools
Knowledge of Commercial, Medicare, and Medicaid PPO and HMO revenue and expense, as well as delegation financial modeling
Beginner to moderate proficiency in Power BI, Tableau or other analytic visualization software
Experience with statistical functions for financial modeling
Solid written and verbal communication skills
All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Responsibilities

Perform unit cost and contract valuation analysis and reporting in support of network contracting negotiations and unit cost management strategies
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
Strategize rates or contract methodology with network management to create optimal contract
Evaluate financial impacts of network configurations across hospital, ancillary and physician provider types
Communicate results of financial impact and analysis to appropriate stakeholder groups (e.g., Network Management; Network Pricing leadership)
Review competitive analysis to identify appropriate pricing rate for provider
Utilize appropriate tools ( i.e., PPM, HPM, UCRT) to model and report impact of provider contracts
Review charge master to ensure trending assumptions are correct
Develop/maintain/update databases and tools needed to perform and support contract modeling
Identify and investigate discrepancies (i.e., difference between actual allowed and modeled payment amount) in claim reimbursement
Other duties as assigned by network pricing leadership
This role may involve some external meetings, and light travel, to negotiate with providers, share performance results and explain complex financial models

Benefits

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.

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