Note: The job is a remote job and is open to candidates in USA. UnitedHealth Group is a global organization that delivers care aided by technology to improve health outcomes. The Senior Network Pricing Consultant will analyze and reprice pharmacy claims to ensure accurate cost management and work on pricing applications and projects related to data manipulation and analysis.
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
Skills
- 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
- PBM Experience
- SQL Server Azure experience
- Technical writing skills
Benefits
- A comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution (all benefits are subject to eligibility requirements)
- Flexibility to telecommute* from anywhere within the U.S.
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