Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities.
Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting.
Growing together. This role within Optum Health's Healthcare Economics Network Strategy & Analytics Department Candidate is responsible for producing their own quality work product but also supports the design & development of new standard work products, refined processes for scaling analytics across markets, and overall data organization that supports our business goals. Candidates should have strong verbal skills, strong written communication skills and demonstrate self-motivation, initiative, and adaptability in a dynamic environment.
This role primarily supports and validates provider and payor network contracting and trend management activities through financial or pricing modeling, negotiation support, analysis, and reporting. The team and this role manage unit cost budgets, reimbursement benchmarking, target setting, performance reporting, maintenance of associated financial models, and other responsibilities as assigned. This role will partner closely with contracting, finance, actuarial, operations, provider relations, and executive leadership teams to evaluate pricing impacts, support provider negotiations, and drive data-informed business decisions.
You'll enjoy the flexibility to work remotely * from anywhere within the U. S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.
C. area, you will be required to work in the office a minimum of four days per week. Primary
Design and implement sound tools utilizing programming languages, BI tools, and other resources to identify principal health care cost and revenue drivers, by market segment and/or by provider/payor, referral patterns, and reimbursement rates Involved with the development of SQL queries, analytical models, dashboards, and automated reporting tools to support executive decision-making Analyze provider reimbursement analysis, pricing model development, and financial impact assessments to support network strategy and contract negotiations Manage unit cost tracking and UCRT entries, ensuring alignment with anticipated negotiation outcomes and reimbursement changes Analyze large healthcare datasets and monitor cost, utilization, reimbursement, and market trends to identify risks and opportunities Ensure pricing, reimbursement, and reporting methodologies are accurate, consistent, statistically sound, and transparent Support initiatives focused on cost containment, network optimization, and operational performance improvement in collaboration with cross-functional stakeholders Present analytical findings and strategic recommendations to leadership and build strong partnerships across contracting, finance, actuarial, and market teams Standardize and document repeatable processes to promote best practices and scalability.
Positions in this function research and investigate key business problems through quantitative analyses of utilization and healthcare costs data. Provides management with statistical findings and conclusions. Identifies potential areas for medical cost improvements and alternative pricing strategies.
Provides data in support of actuarial, financial and utilization analyses. Reviews the work of others Develops innovative approaches Sought out as expert Serves as a leader/ mentor 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
Undergraduate degree or equivalent experience 3+ years of analytical experience in healthcare pricing, managed care, provider reimbursement, network contracting, finance, or healthcare analytics Experience working with healthcare claims and reimbursement methodologies Advanced proficiency in Microsoft Excel, including pivot tables, formulas, and financial modeling Intermediate or greater proficiency in MS-SQL (utilize and edit existing queries, create new queries, including joins and case statements) Knowledge of Provider payment methodologies including: Risk Continuum Model - Fee-for-service, Capitation, Value-based and incentive payment models Medicare, Commercial and Medicaid-based reimbursement Proven solid attention to detail and ability to manage multiple priorities Proven solid analytical and quantitative problem-solving skills Proven effective written and verbal communication skills Proven ability to work collaboratively across cross-functional teams
Bachelor's degree in Finance, Healthcare Administration, Economics, Statistics, Mathematics, Business Analytics, or related field Experience in managed care, health insurance, PPO networks, or provider contracting environments Experience with claims systems, contract modeling software, or reimbursement configuration platforms Knowledge of CMS reimbursement methodologies and regulatory guidelines Familiarity with actuarial or healthcare financial analysis concepts *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc.
In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment.
We comply with all minimum wage laws as applicable. 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. UnitedHealth 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.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.