Sr. Network Pricing Consultant – Telecommute in CA

UnitedHealth Group
May 3, 2021
Cypress, CA
Job Type


UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

You've been working your way to this opportunity for some time now. You've learned to lead. You've built a deep expertise in health care network operations. You've set your sights on having more impact in more ways. It's time to join our leadership team and help UnitedHealth Group as we help make the health system more efficient and effective. You'll leverage your expertise and knowledge in new ways as you strike the balance between health care costs and resources. Managing a team responsible for performing unit cost and contract valuation analysis, you'll ensure that health care contracts are priced accurately and fairly for all involved. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 7 leader.

The Senior Network Pricing Consultant 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. This telecommute position located in the Western US Region conducts unit cost and contract valuation analysis in support of provider negotiations and medical cost management strategies. Responsibilities also include managing unit cost budgets, target setting, performance reporting, and associated financial models. 

If you are located in the state of California, you will have the flexibility to telecommute* as you take on some tough challenges. 

Primary Responsibilities:

  • Develop and execute strategies with business partners in United Health Networks and United Health Clinical to help our contracted entities be successful
  • Independently identify, investigate and communicate cost and utilization patterns for inefficiencies and potential opportunities in attributed member populations to help reduce overall total cost of care
  • Collaborate with UHN and HCE Actuarial teams to develop analytics used to expand Individual Exchange (IEX) provider networks to new markets in the west region
  • Influence pricing strategies and network configuration decisions using a data driven approach
  • Provide consultative advice on use of data as subject matter expert and interpret/summarize analytical findings
  • Evaluate financial impacts of network configurations across hospital, ancillary and physician provider types
  • Analyze and summarize broad impact of changes in network configurations to premium price differentials
  • Work with cross-functional teams across the organization to make strategic decisions supported by data
  • Serve as subject matter expert on data, reporting and methodologies supporting our contracts and relationships
  • Resolve business problems and direct others to resolve business problems that affect multiple functions or disciplines
  • Make decisions about product, service or process decisions that will impact multiple functions and/or customer accounts (internal or external)
  • Extensive external meetings, and some travel, to negotiate with providers, share performance results and explain complex financial models

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
  • 5+ years of experience in creating and using financial modeling tools, spreadsheets, and information acquisition tools including experience in interpreting and reviewing financial modeling results to evaluate the financial impact of contract changes and develop forecasts
  • 3+ years of healthcare managerial experience
  • Demonstrated career progression within healthcare economics, health care pricing, network management, or related discipline
  • Detailed knowledge of Commercial, Medicare, and Medicaid payment methodologies for hospital, ancillary, and physician services
  • Expert level of proficiency in performing financial impact analysis, risk management, and claims data manipulation
  • Expert level proficiency in MS Excel and well versed in PowerPoint 
  • Moderate or higher level experience with SAS and SQL
  • Ability to travel 15% of the time within the West US Region
  • Telecommute or office-based within West Region office locations (PST OR MST)
  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:

  • Postgraduate degree
  • 3+ year of experience working with large databases to produce a focused analysis with proficiency in SAS/SQL for data manipulation and reporting
  • Knowledge of Commercial, Medicare, and Medicaid PPO and HMO revenue and expense, as well as delegation financial modeling
  • Moderate proficiency in Power BI, Tableau or other analytic visualization software
  • Experience with advanced statistical functions for financial modeling
  • Knowledge of the Individual Exchange market place and Medicare provider reimbursement
  • Advanced written and verbal communications skills including negotiation and presentation
  • Successful leadership experience

As we make our networks more efficient and effective, we make life better for millions. That's the opportunity with UnitedHealth Group. Join us. Learn more about how you can start doing your life's best work.(sm)

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)

Colorado Residents Only: The salary range for Colorado residents is $79,700 to $142,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary,  UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy

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.

Job Keywords: Network Pricing, Health Care Financial Analysis, Health Care Pricing, Network Management, SAS, SQL, CA, California, Telecommute, Telecommuter, Work From Home, Remote, Work At Home

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