Note: The job is a remote job and is open to candidates in USA. UnitedHealthcare is simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The Senior Network Pricing Consultant will support healthcare network pricing strategies through complex financial, reimbursement, contract valuation, and provider pricing analyses, while communicating insights and leading analytical projects.
Responsibilities
- Support network pricing strategies and tactics in collaboration with local network field leaders and network managers
- Analyze financial impact of provider contracts
- Perform complex financial and pricing analyses to evaluate reimbursement strategies and network configurations across hospital, ancillary, and physician provider types
- Evaluate financial impact of corporate initiatives and external regulations
- Review payment appendices and develop options for various contracting approaches and methodologies
- Communicate financial impact findings and insights to stakeholder groups
- Conduct financial and network pricing modeling, analysis, and reporting
- Provide mentorship and engage in detailed peer review activities
- Perform unit cost and contract valuation analysis to support network contracting and unit cost management strategies
- Lead large and complex analytical projects to support key business objectives
- Influence pricing strategies and rate development by identifying opportunities or safeguarding favorable structures
- Collaborate with Network Management to strategize rates or contract methodologies
- Review competitive analysis to determine appropriate provider pricing
Skills
- • Bachelor's degree or equivalent relevant work experience
- • 5+ years of experience in healthcare pricing, financial analysis, network pricing, or healthcare economics
- • 5+ years of analytical experience
- • 3+ years of experience with hospital payment methodologies and healthcare products
- • Experience developing and interpreting financial and pricing models to support contract valuation and network strategy
- • Proven advanced Excel skills with demonstrated ability to analyze large, complex datasets efficiently
- • Proven solid communication skills with experience presenting complex analytical findings to stakeholders
- • Proven ability to manage multiple priorities and deliver results in a fast paced environment
- • Proven ability to research and solve problems independently
- • Proven ability to work Central or Eastern Time Zone hours
- You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges
- • Experience with provider payment methodologies, including physician, hospital, and ancillary reimbursement
- • Experience with HPM (Hospital Pricing Model)
- • Experience leveraging enterprise approved automation or AI tools to improve efficiency in analytical workflows
- • Knowledge of commercial, Medicare, and Medicaid PPO/HMO revenue and expense patterns
- • Knowledge of Out of Network pricing, surprise billing regulations, and medical coding (e.g., CPT, DRG, ICD 10)
- • Proficiency with advanced data modeling tools (e.g., Power Pivot, data models, large databases)
- • Proven solid consultative, problem solving, and cross functional collaboration 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
- Development for other roles you may be interested in
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