Healthcare Consultant

Healthcare Economics Network Strategy & AnalyticsOptum 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.This role within Optum Health's Healthcare Economics Network Strategy & Analytics Department Candidate is responsible for producing their own quality work product but also supports the design & development of new standard work products, refined processes for scaling analytics across markets, and overall data organization that supports our business goals. Candidates should have solid verbal skills, solid written communication skills and demonstrate self-motivation, initiative, and adaptability in a dynamic environment.This role primarily supports and validates provider and payor network contracting and trend management activities through financial or pricing modeling, negotiation support, analysis, and reporting. The team and this role manage unit cost budgets, reimbursement benchmarking, target setting, performance reporting, maintenance of associated financial models, and other responsibilities as assigned.This role will partner closely with contracting, finance, actuarial, operations, provider relations, and clinical teams to evaluate pricing impacts, support provider negotiations, and drive data-informed business decisions.You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.Primary Responsibilities:Analyze provider reimbursement analysis, pricing model development, and financial impact assessments to support network strategy and contract negotiationsManage unit cost tracking and UCRT entries, ensuring alignment with anticipated negotiation outcomes and reimbursement changesAnalyze large healthcare datasets and monitor cost, utilization, reimbursement, and market trends to identify risks and opportunitiesInvolved with the development of SQL queries, analytical models, dashboards, and automated reporting tools to support executive decision-makingEnsure pricing, reimbursement, and reporting methodologies are accurate, consistent, statistically sound, and transparentSupport initiatives focused on cost containment, network optimization, and operational performance improvement in collaboration with cross-functional stakeholdersPresent analytical findings and strategic recommendations to leadership and build solid partnerships across contracting, finance, actuarial, and market teamsStandardize and document repeatable processes to promote best practices and scalabilityYou'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:2+ years of analytical experience in healthcare pricing, managed care, provider reimbursement, network contracting, finance, or healthcare analytics2+ years of experience working with healthcare claims and reimbursement methodologies2 + years of experience - Advanced proficiency in Microsoft Excel, including pivot tables, formulas, and financial modelingProven solid analytical and quantitative problem-solving skillsProven knowledge of Provider payment methodologies including: Fee-for-service, DRG, APC, Percent of billed charges, Medicare-based reimbursement, Value-based payment modelsProven solid attention to detail and ability to manage multiple prioritiesProven effective written and verbal communication skillsAbility to work collaboratively across cross-functional teamsPreferred Qualifications:Bachelor's degree in finance, Healthcare Administration, Economics, Statistics, Mathematics, Business Analytics, or related fieldExperience in managed care, health insurance, PPO networks, or provider contracting environmentsExperience with claims systems, contract modeling software, or reimbursement configuration platformsKnowledge of CMS reimbursement methodologies and regulatory guidelinesFamiliarity with actuarial or healthcare financial analysis conceptsExperience in utilizing and editing existing queries, create new queries, including joint and case statements in programs such as SQL, Alteryx, Snowflake, or any advanced analytical platformsCore Competencies:Healthcare pricing and reimbursement strategyFinancial modeling and cost trend analysisData analytics and reporting automationStrategic thinking and problem-solvingCross-functional collaborationCommunication and presentation skillsProcess improvement and operational optimizationProject and stakeholder managementPay 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.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-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.UnitedHealth Group is an Equal Employment Opportunity employer under applicable law 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, or any other characteristic protected by local, state, or federal laws, rules, or regulations.UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.