Senior Network Pricing Consultant - Remote
$91.7k - $163.7kReliant Medical Group
Join UnitedHealthcare
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.
Primary Responsibilities:
- Support network pricing strategies and tactics in collaboration with local network field leaders and network managers
- Analyze financial impact of provider contracts
- Perform complex financial and pricing analyses to evaluate reimbursement strategies and network configurations across hospital, ancillary, and physician provider types
- Evaluate financial impact of corporate initiatives and external regulations
- Review payment appendices and develop options for various contracting approaches and methodologies
- Communicate financial impact findings and insights to stakeholder groups
- Conduct financial and network pricing modeling, analysis, and reporting
- Provide mentorship and engage in detailed peer review activities
- Perform unit cost and contract valuation analysis to support network contracting and unit cost management strategies
- Lead large and complex analytical projects to support key business objectives
- Influence pricing strategies and rate development by identifying opportunities or safeguarding favorable structures
- Collaborate with Network Management to strategize rates or contract methodologies
- Review competitive analysis to determine appropriate provider pricing
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.
Required Qualifications:
- Bachelor's degree or equivalent relevant work experience
- 5+ years of experience in healthcare pricing, financial analysis, network pricing, or healthcare economics
- 5+ years of analytical experience
- 3+ years of experience with hospital payment methodologies and healthcare products
- Experience developing and interpreting financial and pricing models to support contract valuation and network strategy
- Proven advanced Excel skills with demonstrated ability to analyze large, complex datasets efficiently
- Proven 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
- Proven ability to research and solve problems independently
- Proven ability to work Central or Eastern Time Zone hours
Preferred Qualifications:
- Experience with provider payment methodologies, including physician, hospital, and ancillary reimbursement
- Experience with HPM (Hospital Pricing Model)
- Experience leveraging enterprise approved automation or AI tools to improve efficiency in analytical workflows
- Knowledge of commercial, Medicare, and Medicaid PPO/HMO revenue and expense patterns
- 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)
- Proven solid consultative, problem solving, and cross functional collaboration skills
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
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.
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.
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