Note: The job is a remote job and is open to candidates in USA. Optum delivers technology-enabled health care services that help people live healthier lives and improve health outcomes. The Network Pricing Consultant supports provider network contracting and unit cost management through financial modeling, pricing analysis, reporting, and data-driven recommendations. The role also partners with cross-functional teams to manage client and pharmacy performance and develop new products and strategic initiatives.
Responsibilities
- Support the development of new products or strategic initiatives aimed at reducing the total cost of care
- Represent Network Pricing in cross functional meetings (governance, strategy discussions, client implementations)
- Transforms data into meaningful and easy to understand insights for various audiences
- Create specifications to bring data into a common structure, create product specifications and models, developing data solutions to support data analysis
- Partner with stakeholders to understand data requirements and business needs and develop tools and models, and to assist building of dashboards and data visualizations
- Develop insights and proposals for improved business processes to enable speedy deployment and testing of future projects
- Build operational workflows, documentation and QA controls for repeatable and compliant pricing execution
- Product, service, or process decisions are most likely to impact multiple groups of employees and/or customers (internal or external)
- Lead and perform financial analysis and modeling as it relates to setting prescription drug prices
- Monitor pricing performance against financial targets, approve deviations, and adjust strategies as necessary
- Perform data mining, claims research, and QA drilling down on drivers associated to client performance
- Prepare regular and ad hoc reports on pricing performance, financial outcomes, and client reporting
- Concisely summarize and communicate complex concepts, statistical findings and conclusions in ways that can be understood by a variety of audiences
- Translate and decipher contract language as it relates to client commitments and reconciliation
- Proactively identify and resolve issues
- Partner with other departments including Underwriting, Legal, Operations, and Account Management to effectively oversee client performance management
- Conduct or support market intelligence research for competitive drug costs, including supply chain, insured benefits, discount card (i.e. cash card), NADAC, and other reference points
- Enhance and utilize pricing trackers and tools to forecast trends and recommend adjustments for new product offering
Skills
- 5+ years of analytical experience in financial analysis, healthcare pricing, network management, healthcare economics, or related discipline
- 2+ years of experience in creating and using financial modeling tools, spreadsheets, and information acquisition tools including experience in interpreting and/or displaying financial modeling results to inform actionable decisions
- Advanced proficiency in performing financial impact analysis, risk management, and data manipulation
- Previous Healthcare or PBM experience
- Experience in product development or supporting new service offerings
- Proficiency in SQL, Python and/or Tableau
- Proven solid written and verbal communication skills
Benefits
- Flexibility to work remotely from anywhere within the U.S.
- A comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution (all benefits are subject to eligibility requirements)
- Development for other roles you may be interested in
Company Overview
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