Sr. Network pricing Consultant - PST or MST job at UnitedHealth Group, San Diego

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)

The Senior Consultant, Healthcare Economics Network Pricing 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 telecommute position located in the Western US Region conducts unit cost and contract valuation analysis in support of negotiations and cost management strategies. Responsibilities also include managing unit cost budgets, target setting, performance reporting, and associated financial models. 

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. or be office-based within West Region office locations (PST OR MST) as you take on some tough challenges. 

Primary Responsibilities:

• Develop and execute strategies with business partners in United Health Networks and United Health Clinical to help our contracted entities be successful
• Independently identify, investigate and communicate cost and utilization patterns for inefficiencies and potential opportunities in attributed member populations to help reduce overall total cost of care
• Influence pricing strategies and network configuration decisions using a data driven approach
• Provide consultative advice on use of data as subject matter expert and interpret/summarize analytical findings
• Evaluate financial impacts of network configurations across hospital, ancillary and physician provider types, to support actuarial, financial and utilization analyses related to product and pricing initiatives
• Analyze and summarize broad impact of changes in network configurations to premium price differentials
• Partner with Healthcare Economics teams, Network Contracting and various stakeholders to support operational and product partners
• Serve as subject matter expert on data, reporting and methodologies supporting our contracts and relationships
• Seek opportunities to improve processes and identify areas of improvement specifically related to data reliability, efficiency and quality (implement and scale best practices) to help establish quality control measures
• Create and maintain applicable project documentation for assigned initiatives
• This role will involve extensive external meetings, some travel to negotiate with providers, sharing performance results and explaining complex financial models

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.

Required Qualifications:

• Undergraduate degree
• 3+ years of demonstrated career progression within healthcare economics, health care pricing, network management, or related discipline
• 3+ years of healthcare experience
• 3+ years of experience in creating and using financial modeling tools, spreadsheets, and information acquisition tools including experience in interpreting and reviewing financial modeling results to evaluate the financial impact of contract changes and develop forecasts
• Detailed knowledge of Commercial, Medicare, and Medicaid payment methodologies for hospital, ancillary, and physician services
• High level of proficiency in performing financial impact analysis, risk management, and claims data manipulation
• Expert level proficiency in MS Excel and well versed in PowerPoint 
• Moderate or higher level experience with SAS and SQL
• Ability to travel 15% of the time within the US
• Telecommute or office-based within West Region office locations (PST OR MST)
• Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance

Preferred Qualifications:

• Postgraduate degree
• 1+ years of experience working with large databases to produce a focused analysis with proficiency in SAS/SQL for data manipulation and reporting
• 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 advanced statistical functions for financial modeling
• Successful leadership experience
• Solid written and verbal communication skills including negotiation and presentation

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Colorado, Connecticut or Nevada Residents Only: The Salary range for Colorado residents is $82,100 to $146,900. The Salary range for Connecticut/Nevada residents is $90,500 to $161,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.