Senior Healthcare Economics Consultant

6 days ago

Tucson, United States UnitedHealth Group Full time

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.

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