UnitedHealthcare ยท 1 month ago
Senior Provider Network Pricing Analyst - Remote for Pacific / Hawaii Time Zones
United States
Full-time
Remote
Mid, Senior Level
$59K/yr - $105K/yr
1+ years expUnitedHealthcare is focused on simplifying the health care experience and creating healthier communities. The Healthcare Economics Network Pricing Analyst will support and validate Provider Network contracting and unit cost management activities through financial modeling and analysis, while also managing unit cost budgets and performance reporting.
FitnessHealth CareWellness
Responsibilities
Perform unit cost and contract valuation analysis and reporting in support of network contracting negotiations and unit cost management strategies
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
Strategize rates or contract methodology with network management to create optimal contract
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 rate for provider
Utilize appropriate tools ( i.e., PPM, HPM, UCRT) to model and report impact of provider contracts
Review charge master to ensure trending assumptions are correct
Develop/maintain/update databases and tools needed to perform and support contract modeling
Identify and investigate discrepancies (i.e., difference between actual allowed and modeled payment amount) in claim reimbursement
Other duties as assigned by network pricing leadership
This role may involve some external meetings, and light travel, to negotiate with providers, share performance results and explain complex financial models
Qualification
Required
Beginner level of 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)
Preferred
1+ years of experience working with large databases to produce a 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
All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Benefits
Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution
Company
UnitedHealthcare
UnitedHealthcare helps people live healthier lives by simplifying the health care experience.
10001+ employees
H1B Sponsorship
UnitedHealthcare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (48)
2024 (26)
2023 (45)
2022 (61)
2021 (60)
2020 (68)
Funding
Current Stage
Late StageLeadership Team
R
Rebecca Madsen
Chief Consumer Officer
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