The successful candidate consults and validates Provider Network (physicians, hospitals, ancillary facilities, etc.) contracting and unit cost management activities through financial modeling, analysis of utilization, and reporting. They will also conduct unit cost and contract valuation analysis in support of network provider rate negotiations and unit cost management strategies. Other duties include managing unit cost budgets, target setting, performance reporting, and being responsible for related financial models.
This position will primarily support the East Region markets and is likely to be a telecommute arrangement.
You\'ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:- Support network pricing strategies and tactics, consulting and collaborating with local network field leaders and network managers
- Analyze financial impact of provider contracts (e.g., facility; physician; ancillary)
- Analyze payment appendices to provide options for various contracting approaches and methodologies
- Communicate results of financial impact and analysis to appropriate stakeholder groups (e.g., Network Management, Network Pricing leadership)
- Effectively summarize information while providing supporting data to a variety of audiences
- Conduct financial and network pricing modeling, analysis and reporting
- Peer review the analytical models of others
- Perform unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies
- Influence pricing strategies and rate development by highlighting opportunities for improvement or protecting favorable rate structures
- Strategize with network management to create optimal contracts
- Review competitive analysis to identify appropriate pricing rates for providers
- Perform various ad hoc projects in a timely and accurate manner
- Demonstrate a consultative, customer focused mindset
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
- 5+ years of analytical experience in financial analysis, health care pricing, network management, health care economics or related discipline
- 3+ years of experience with provider payment methodologies and healthcare products
- 2+ years of experience in creating and using financial modeling tools, spreadsheets and information acquisition tools
Intermediate level of proficiency in performing financial impact analysis, risk management and data manipulation - Expert level proficiency in MS Excel
Preferred Qualifications:- Undergraduate degree in Math, Statistics, Finance, Economics or related field of study
- 3+ years of experience with provider payment methodologies and healthcare products
- Experience with medical coding (CPT, MSDRG, REV, ICD-10, etc.)
- Knowledge of MS Access
- Knowledge of Commercial, Medicare, and Medicaid PPO and HMO revenue and expense, as well as delegation financial modeling
*All employees working remotely will be required to adhere to UnitedHealth Group\'s Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you\'ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
