Senior Consultant, Payer Performance - Remote

Senior Consultant, Payer Performance

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Optum Health Enterprise Payer Team is responsible for owning, driving, and optimizing Optum Health's payer portfolio to achieve sustainable value-based care relationships. The Senior Consultant, Payer Performance will play a critical role in proactively managing and identifying remediation and growth opportunities to improve the payer portfolio. This individual will be expected to:

• Influence payer strategies in a fast-paced, performance-focused environment
• Provide quantitative and qualitative interpretation of payer performance to help advance Optum Health goals
• Partner to develop and create data centric tracking and reporting on key organizational priorities
• Foster relationships with cross-functional partners to solve critical business initiatives
• Proactively identify problems and develop recommended solutions

This individual will need to be able to function in a diverse environment with senior level stakeholders across internal and external stakeholder groups, abstract and fluid environments, and simultaneous deadlines. The position requires an ability to comprehend local markets' strategies while demonstrating awareness of broader systems across the enterprise, both strategically and tactically. Organizational agility will be required - building meaningful relationships and facilitating decision-making to continue achieving Optum Health's value-based care growth agenda.

You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Develop a data-driven, proactive approach for ongoing assessment of Optum Health's payer performance
• Evaluate financial impact of payer negotiations, terminations, regulatory changes, or other OH strategic shifts
• Own source of truth tracking for active payer negotiations and/or terminations
• Partner with Finance and Healthcare Economics to ensure consistent modeling, measurement, and reporting (i.e., scenario modeling and $ impacts, budget vs. actuals, etc.)
• Enhance reporting to improve ability to understand, measure and compare payer performance
• Anticipate leadership needs; proactively source / package data to inform OH POV and strategic decisions
• Support ongoing executive leadership updates and ad-hoc requests
• Key contributor to Medicare Advantage Annual Enrollment Period (AEP) reporting & impact analysis
• Research and inform strategic recommendations around value-based care product positioning

Skills Needed:

• Ability to convey findings in a cohesive story, including summarizing insights
• Experience working with all levels of management across multiple functions and business partners
• Proven record of managing competing priorities and a rapidly changing business environment
• Ability to anticipate and make recommendations that resolve key operational or functional gaps
• Passion for collaborating with external and internal constituents, gaining consensus/support, and managing stakeholder input/approval

Required Qualifications:

• Bachelor's degree in Business Administration, Analytics, Finance or a related field
• 5+ years of relevant experience in healthcare operations, strategy, growth, or consulting roles
• Experience building financial models and translating data into actionable business insights
• Demonstrated problem solving, analysis, and resolution at strategic and functional levels
• Proven critical thinking skills with experience managing multiple priorities and resolving data inconsistencies
• Demonstrated ownership, accountability, and readiness to take on leadership responsibilities
• Self-starter with comfort navigating ambiguous situations and problems

Preferred Qualifications:

• Experience and understanding of value-based care and different risk constructs
• Solid understanding of payer and provider relationships in the healthcare industry
• Understanding of Medicare Advantage and/or Medicare Original Products
• Solid financial acumen and ability to analyze financial, clinical and/or operational data
• Solid Excel skills with financial & return on investment modeling

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). The salary for this role will range from $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone deserves the opportunity to live their healthiest life. UnitedHealth Group is an Equal Employment Opportunity employer and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.