Sr. Healthcare Economics Consultant - Remote
Company: UnitedHealth Group
Location: Tucson
Posted on: November 19, 2024
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Job 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 equitable.
Ready to make a difference? Join us to start Caring. Connecting.
Growing together.
This position supports and validates Provider Network (physicians,
hospitals, pharmacies, ancillary facilities, shared/full risk
delegation, etc.) contracting and unit cost management activities
through financial modeling, analysis of utilization, and reporting.
Conducts unit cost and contract valuation analysis in support of
network contracting negotiations and unit cost management
strategies. Manages unit cost budgets, target setting, performance
reporting, and associated financial models.
This position will primarily support the West Region (Colorado to
Hawaii). This position is based in Cypress, CA but telecommute
arrangement will be considered based on work experience.
Challenge can often be its own reward. But why settle for just
being challenged when you can also be nurtured, mentored and
supported in building an impact and fast paced career? With
UnitedHealth Group you can have all of the above, every day. Here's
your opportunity to combine expertise and compassion in new ways as
you strike the balance between health care costs and resources. In
this senior role, you'll ensure that health care contracts are
priced accurately and fairly for all involved. As you do, you'll
discover the impact you want and the resources, backing and
opportunities that you'd expect from a Fortune 5 leader.
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 (e.g., facility;
physician; ancillary)
Analyze financial impact of corporate initiatives (e.g., policy
changes; healthcare affordability) or external regulations (e.g.,
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 contract
Review competitive analysis to identify appropriate pricing rate
for provider
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:
Undergraduate degree
6+ years of analytical experience in financial analysis, healthcare
pricing, network pricing, healthcare economics or related
discipline
4+ years of experience with provider payment methodologies and
healthcare products
Presentation experience to internal or external stakeholders or
customers
Intermediate ability to interpret and review financial modeling
results to evaluate the financial impact of contract changes and
develop forecasts
Advanced level of proficiency in MS Excel
Proven excellent financial impact analysis, risk management, and
data manipulation skills
Proven solid interpersonal, collaboration, negotiation and
communication skills
Proven excellent communication skills, both written and verbal
Proven ability to manage multiple projects simultaneously and meet
deliverable deadlines
Proven ability to research and solve problems independently
Preferred Qualifications:
Postgraduate degree in Math, Statistics, Finance, Economics, or
Actuarial Science
Experience in MS Access, SAS, SQL, R, or Python
Experience with advanced statistical functions for financial
modeling
Experience with medical coding (CPT, MSDRG, REV, ICD-10, etc.)
Experience with provider capitation, both diagnostic
risk-adjustment and age/sex adjusted rate banding
Specific experience with credibility
Knowledge of Commercial, Medicare, and Medicaid PPO and HMO revenue
and expense, as well as delegation financial modeling
Understanding of financial statements (i.e., revenue, expense,
gross margin, net income, EBIT)
*All employees working remotely will be required to adhere to
UnitedHealth Group's Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New
York, Rhode Island, or Washington Residents Only: The salary range
for this role is $88,000 to $173,200 annually. Pay is based on
several factors including but not limited to local labor markets,
education, work experience, certifications, etc. UnitedHealth Group
complies with all minimum wage laws as applicable. In addition to
your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching
choice of benefits and incentives.
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.
Diversity creates a healthier atmosphere: UnitedHealth Group is an
Equal Employment Opportunity/Affirmative Action employer and all
qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, age, national origin,
protected veteran status, disability status, sexual orientation,
gender identity or expression, marital status, genetic information,
or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are
required to pass a drug test before beginning employment.
Keywords: UnitedHealth Group, Mesa , Sr. Healthcare Economics Consultant - Remote, Healthcare , Tucson, Arizona
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