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Job Details

UnitedHealth Group

Sr. Network Pricing Consultant - Telecommute


Healthcare Network Director



Cypress, California, United States

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

You've been working your way to this opportunity for some time now. You've built a deep expertise in health care network operations. You've set your sights on having more impact in more ways. It's time to join our team and help UnitedHealth Group as we help make the health system more efficient and effective. You'll leverage your expertise and knowledge 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 health care contracts are priced accurately and fairly for all involved. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 5 leader.

The Senior Consultant, Healthcare Economics Network Pricing supports the west region pricing team in various capacities, including but not limited to pulling/validating/transforming data, report generation/creation and all associated functionalities (includes becoming SMA of various data stores/process). Data in-scope for this role includes value based (cap/ACO/risk), physicians, hospitals, pharmacies, ancillary facilities. This onsite/hybrid/telecommute position supports team members working on unit cost and contract valuation analysis in support of negotiations and cost management strategies. Responsibilities also include managing multiple deliverables and ensuring continuity of information while making recommendations.

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 data management strategies with business partners in United Health Networks and United Health Clinical to help our contracted entities/internal partners be successful
  • Collaborate with partners to identify, investigate, and communicate cost and utilization patterns for inefficiencies and potential opportunities in various member populations to help reduce overall total cost of care
  • Solves complex problems and finds innovative sustainable solutions
  • Provide consultative advice on use of data as subject matter expert and interpret/summarize analytical findings
  • Collects, analyzes, and performs quality assurance on analytic initiatives that consume data from multiple sources
  • 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
  • Capture complex/nuanced business requirements and needs thru meeting with various internal stakeholders

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
  • Experience in 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
  • Experience working with SQL/SAS querying techniques related to relational databases
  • Experience within an Enterprise Data Warehouse environment / multi-source warehouse
  • Expertise in data manipulation, financial impact analysis and data risk management
  • Proficiency in pulling data used in performing financial impact analysis, risk management, and claims data manipulation
  • Proficiency in MS Excel and well versed in PowerPoint
  • Ability to travel 15% of the time within the US
  • Telecommute or office-based within West Region office locations
  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifications:

  • Knowledge of Commercial, Medicare, and Medicaid PPO and HMO revenue and expense, as well as delegation financial modeling/understanding of various payment methodologies
  • 5+ years of experience in Healthcare or Analytics
  • 5+ years of demonstrated career progression within healthcare economics, health care pricing, network management, or related discipline
  • Experience working with UHG systems including UGAP, UDW, UNET, MDE, & Galaxy
  • Experience with advanced statistical functions for financial modeling
  • Ability to manage to key dates related to project timelines/across different partners
  • Excellent critical thinking and problem-solving skills
  • 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 require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, 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)

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.

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

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.