Senior Network Pricing Consultant

Role Description

At UnitedHealthcare, we’re 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. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

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

• Own and maintain Out of Network and hospital based physician pricing models, ensuring accuracy, consistency, and compliance with Federal No Surprises Act and state Surprise Medical Bill regulations.
• Apply deep knowledge of OON and surprise billing programs to support pricing strategy and dispute resolution initiatives.
• Perform complex financial and pricing analyses to evaluate reimbursement strategies and network configurations across hospital, ancillary, and physician provider types.
• Develop, enhance, and maintain analytical and financial models, including SQL based reporting and advanced Excel formulas/macros.
• Independently produce ad hoc analyses and customized reports to support enterprise and pricing needs, including provider terminations.
• Partner cross functionally to prepare insights, research, and data driven talking points that inform pricing and network strategy decisions.
• Serve as a subject matter expert for network pricing, confidently presenting findings, resolving model issues, and translating complex analysis into concise recommendations for leadership.

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.

Qualifications

• Bachelor’s degree or equivalent relevant work experience.
• 5+ years of experience in healthcare pricing, financial analysis, network pricing, or healthcare economics.
• Experience developing and interpreting financial and pricing models to support contract valuation and network strategy.
• Advanced Excel skills with demonstrated ability to analyze large, complex datasets efficiently.
• Working experience with SQL to support ad hoc analysis and reporting.
• Solid communication skills with experience presenting complex analytical findings to stakeholders.
• Proven ability to manage multiple priorities and deliver results in a fast paced environment.
• Ability to work Central or Eastern Time Zone hours.

Requirements

• Experience with provider payment methodologies, including physician, hospital, and ancillary reimbursement.
• Experience with PPM (Physician Pricing Model) and UCRT (Unit Cost Reporting Tool).
• Experience leveraging enterprise approved automation or AI tools to improve efficiency in analytical workflows.
• Knowledge of Out of Network pricing, surprise billing regulations, and medical coding (e.g., CPT, DRG, ICD 10).
• Proficiency with advanced data modeling tools (e.g., Power Pivot, data models, large databases).
• Solid consultative, problem solving, and cross functional collaboration skills.

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase.
• 401k contribution (all benefits are subject to eligibility requirements).
• Salary range from $91,700 to $163,700 annually based on full-time employment.

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.