Job Details

Manager Network Pricing - Remote in Cypress, CA

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Overview

At UnitedHealthcare, were simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. This role involves performing unit cost and contract valuation analysis to ensure healthcare contracts are priced accurately and fairly, supporting network contracting negotiations and unit cost management strategies. The position generally supports Southern California; based in Cypress, CA, with potential remote arrangement based on work experience.

Youll enjoy the flexibility to work remotely from anywhere within the U.S. as you tackle challenging problems.

Responsibilities

• Support network pricing strategies and tactics, in collaboration with local network field leaders and network managers
• Analyze financial impact of provider contracts (facility, physician, ancillary)
• Analyze financial impact of corporate initiatives (policy changes, healthcare affordability) or external regulations (healthcare reform)
• 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)
• Conduct financial and network pricing modeling, analysis and reporting
• Perform unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies
• Lead large, complex projects to achieve key business objectives
• Influence pricing strategies and rate development by highlighting opportunities for improvement or protecting favorable rate structures
• Strategize rates or contract methodology with network management to create optimal contracts
• Review competitive analysis to identify appropriate pricing rates for providers

Required Qualifications

• 8+ years of analytical experience in financial analysis, healthcare pricing, network pricing, healthcare economics or related discipline
• 5+ years of experience with provider payment methodologies and healthcare products
• 5+ years of experience in creating and using financial modeling tools, spreadsheets and information acquisition tools
• Experience with provider capitation, both diagnostic risk-adjustment and age/sex adjusted rate banding
• Experience in interpreting and reviewing financial modeling results to evaluate financial impact of contract changes and develop forecasts
• Presentation experience to internal or external stakeholders or customers
• Expertise in financial impact analysis, risk management and data manipulation
• Expert level proficiency in MS Excel
• Strong interpersonal, collaboration, negotiation and communication skills
• Excellent written and verbal communication skills
• Ability to manage multiple projects simultaneously and meet deadlines
• Ability to research and solve problems independently

Preferred Qualifications

• Experience in MS Access, SAS, SQL, R, or Python
• Experience with advanced statistical functions for financial modeling
• Experience with medical coding (CPT, MS-DRG, REV, ICD-10, etc.)
• 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 Groups Telecommuter Policy

Pay is based on several factors including local labor markets, education, work experience, certifications, etc. In addition to salary, benefits include a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution. The salary range for this role is $89,900 to $160,600 annually, based on full-time employment. We comply with all applicable minimum wage laws.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

UnitedHealth Group is an Equal Employment Opportunity employer. We are committed to mitigating our impact on the environment and delivering equitable care that addresses health disparities. UnitedHealth Group is a drug-free workplace; candidates are required to pass a drug test before beginning employment.

Seniority level: Mid-Senior level

Employment type: Full-time

Job function: Information Technology

Industries: Hospitals and Health Care