Healthcare Economics Consultant -Network Pricing/Hospital Contracting - Remote

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Optum is looking for a motivated, self-starter to join our Institutional Contracting Analytics team. In this role, you will support contract negotiations and unit-cost pricing initiatives for institutional provider types (ie.

hospitals, skilled nursing facilities, ambulatory surgery centers). The HCE consultant will perform complex analysis using SQL and Excel to help lower the cost of care while improving quality.

To succeed in this role, you will have excellent project and time management skills with a solid desire to learn as you grow.

Have a basic understanding of facility and / or provider contracts and the key terms impacting quality and financial performance.

The ideal candidate will have experience calculating key metrics for hospital cost and utilization (APK, PMPM). Advanced skills in SQL and Excel will be integral for day-to-day activities and being able to work in a fast-paced setting.

Experience with the Microsoft Power Platform will also be helpful.

You’ll enjoy the flexibility to work remotely

from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities :

• Provide support and analyses of provider contracting (hospital, ancillary, pharmacy, physician) and unit cost management activities
• Create detailed financial and network pricing models
• Perform regular and repeatable data extraction, aggregation, and quality checking from multiple sources and tables in support of trend identification, root cause analysis
• Assess and interpret business requirements and propose technical solutions
• Identify solutions to non-standard requests and problems
• Solve moderately complex problems and / or conduct moderately complex analyses
• Work with minimal guidance; seek guidance on complex tasks
• Translate concepts into practice
• Provide explanations and information to others on data availability, content and interpretation
• Research data quality questions; present findings; and suggest solutions as necessary
• Create custom data extracts and aggregation processes in support of one time studies
• Participate in projects by contributing to database creation, maintenance, and enhancement
• Create reporting tools to investigate sources of variations
• Produce and review reports

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 :

• 2+ years of experience in health care data analytics (Financial and Quality analytics)
• 2+ years of experience with provider payment methodologies (i.e. fee for service or capitation)
• 2+ years of health care experience working with hospital claims data and medical coding (revenue codes, HCPCS / CPT codes, DRG, etc.)
• 2+ years of experience in network pricing OR finance experience
• Experience tracking trends, finding variances and developing reports in SQL and excel
• Experience building financial and pricing models in excel
• Experience working with large data sets
• Advanced level of proficiency working with MS Excel (PivotTables, SumIfs, Vlookup, etc)
• Basic proficiency with SQL (Joins, filter data, etc.)

Preferred Qualifications :

• Hospital pricing and cost driver research and analytics experience
• Proven to be detail-oriented self-starter, critical thinker, with analytic skills and evidence of creative, proactive problem solving
• Proven ability to effectively manage multiple priorities
• 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, Washington, Washington, D.C. Residents Only : The salary range for this role is $70, to $, 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 k 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 : OptumCare is an Equal Employment Opportunity / Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.