Senior Provider Network Pricing Analyst - Remote Pacific​/Hawaii Time Zones

The Healthcare Economics Network Pricing Analyst supports and validates Network (ACO's, physicians, hospitals, pharmacies, ancillary facilities, etc.) contracting and unit cost management activities through financial modeling, analysis of utilization, and reporting.

If you are located in the Pacific or Hawaii time zones, you will have the flexibility to work remotely as you take on some tough challenges.

• Perform unit cost and contract valuation analysis and reporting in support of network contracting negotiations and unit cost management strategies.
• Analyze the 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.
• Strategize rates or contract methodology with network management to create optimal contracts.
• Evaluate financial impacts of network configurations across hospital, ancillary and physician provider types.
• Communicate results of financial impact and analysis to appropriate stakeholder groups (e.g., Network Management; Network Pricing leadership).
• Review competitive analysis to identify appropriate pricing rates for providers.
• Utilize appropriate tools (PPM, HPM, UCRT) to model and report impact of provider contracts.
• Review charge master to ensure trending assumptions are correct.
• Develop, maintain, and update databases and tools needed to perform and support contract modeling.
• Identify and investigate discrepancies (difference between actual allowed and modeled payment amount) in claim reimbursement.
• Other duties as assigned by network pricing leadership.
• May involve some external meetings, light travel, to negotiate with providers, share performance results, and explain complex financial models.

• Beginner level proficiency in performing financial impact analysis, risk management, and claims data manipulation.
• Moderate level proficiency in MS Excel.
• Telecommute or office-based within West Region office locations (PST or Hawaii).

• 1+ year experience working with large databases to produce focused analysis with proficiency in SAS/SQL for data manipulation and reporting.
• Internship experience or other healthcare/financial experience and background.
• Knowledge of Commercial, Medicare, and Medicaid payment methodologies for hospital, ancillary, and physician services.
• Beginner or higher level experience with SAS, SQL, or other relational database tools.
• Knowledge of Commercial, Medicare, and Medicaid PPO and HMO revenue and expense, as well as delegation financial modeling.
• Beginner to moderate proficiency in Power BI, Tableau or other analytic visualization software.
• Experience with statistical functions for financial modeling.
• Solid written and verbal communication skills.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, and more. The salary range for this role is $58,800 to $105,000 annually for full‑time employment. Eligibility for a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401(k) contribution (subject to eligibility requirements) is also offered.

Minimum of 2 business days, or until a sufficient candidate pool has been collected.

United Health 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.

All candidates are required to pass a drug test before beginning employment.