Network Pricing Consultant - Remote

Posted 2025-03-15
Remote, USA Full-time Immediate Start

About the position

At UnitedHealthcare, we are dedicated to simplifying the health care experience and creating healthier communities. The Network Pricing Consultant plays a crucial role in supporting and validating Provider Network contracting and unit cost management activities. This position involves financial modeling, analysis of utilization, and reporting to ensure that health care contracts are priced accurately and fairly. The successful candidate will conduct unit cost and contract valuation analysis to support network contracting negotiations and unit cost management strategies. Additionally, the role includes managing unit cost budgets, target setting, and performance reporting, along with being responsible for related financial models. This position primarily supports the Southeast Region markets and is likely to be a telecommute arrangement. The role offers the opportunity to combine expertise and compassion in new ways, striking a balance between health care costs and resources. The Network Pricing Consultant will work closely with local network field leaders and network managers to support network pricing strategies and tactics. They will analyze the financial impact of provider contracts, communicate results to stakeholders, and conduct financial and network pricing modeling, analysis, and reporting. The successful candidate will also peer review analytical models, influence pricing strategies, and perform competitive analysis to identify appropriate pricing rates for providers. This role requires a customer service mindset and the ability to manage multiple projects simultaneously while meeting deliverable deadlines. At UnitedHealth Group, you will be rewarded and recognized for your performance in an environment that challenges you and provides clear direction for success.

Responsibilities
? Support network pricing strategies and tactics, in collaboration with local network field leaders and network managers
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? Analyze financial impact of provider contracts (e.g., facility; physician; ancillary)
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? Analyze payment appendices to provide options for various contracting approaches and methodologies
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? Communicate results of financial impact and analysis to appropriate stakeholder groups (e.g., Network Management, Network Pricing leadership)
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? Effectively summarize information while providing supporting data to a variety of audiences
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? Conduct financial and network pricing modeling, analysis and reporting
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? Peer review the analytical models of others
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? Perform unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies
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? Influence pricing strategies and rate development by highlighting opportunities for improvement or protecting favorable rate structures
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? Strategize with network management to create optimal contracts
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? Review competitive analysis to identify appropriate pricing rates for providers
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? Perform various ad hoc projects in a timely and accurate manner
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? Demonstrate a customer service mindset

Requirements
? Undergraduate degree in Math, Statistics, Finance, Economics or related field of study
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? 4+ years of analytical experience in financial analysis, healthcare pricing, network pricing, healthcare economics or related discipline
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? Presentation experience to internal or external stakeholders or customers
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? Familiarity with interpreting and reviewing financial modeling results to evaluate the financial impact of contract changes and developing forecasts
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? Advanced level of proficiency in Microsoft Excel
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? Proven ability to manage multiple projects simultaneously and meet deliverable deadlines
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? Proven ability to research and solve problems independently
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? Proven excellent financial impact analysis, risk management, and data manipulation skills
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? Proven excellent interpersonal, collaboration, negotiation, and communication skills

Nice-to-haves
? Postgraduate degree in Math, Statistics, Finance, Economics or Actuarial Science
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? 3+ years of experience with provider payment methodologies and healthcare products
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? Experience with MS Access, SAS and/or SQL
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? Experience with advanced statistical functions for financial modeling
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? Experience with medical coding (CPT, MSDRG, REV, ICD-10, etc.)
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? Knowledge of Commercial, Medicare, and Medicaid PPO and HMO revenue and expense, as well as delegation financial modeling

Benefits
? Comprehensive benefits package
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? Incentive and recognition programs
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? Equity stock purchase
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? 401k contribution

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