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Optum

Consultant, Healthcare Economics & Hospital Contracting Analytics

Posted An Hour Ago
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In-Office
Los Alamitos, CA, USA
73K-130K Annually
Junior
In-Office
Los Alamitos, CA, USA
73K-130K Annually
Junior
Leads healthcare reimbursement analysis, pricing models, financial impact assessments, claims-data analysis, dashboards, and executive reporting supporting provider network strategy. The role evaluates cost trends, utilization, contract pricing scenarios, fee schedule changes, and reimbursement performance; partners with contracting, finance, actuarial, and operations teams; supports negotiations; improves reporting automation; and mentors analytical staff.
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Requisition Number: 2375254
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.
The Senior Healthcare Economics Consultant (Network Pricing & Analytics) is responsible for supporting provider reimbursement analysis, pricing strategy support, financial modeling, and analytical reporting activities across provider network initiatives. This role oversees complex healthcare data analysis, dashboard development, reimbursement modeling, and cost trend analysis to support network contracting, operational performance, and enterprise cost management strategies.
The Manager partners closely with contracting, clinical, finance, actuarial, operations, provider relations, and executive leadership teams to evaluate pricing impacts, support provider negotiations, and drive data-informed business decisions. This role also provides leadership and mentorship to analytical staff while advancing reporting automation, analytical capabilities, and operational efficiencies.
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 Responsibilities:
  • Lead provider reimbursement analysis, pricing model development, and financial impact assessments supporting network strategy initiatives
  • Manage large healthcare datasets including medical claims, reimbursement, provider, utilization, and financial performance data
  • Oversee development and optimization of SQL queries, analytical models, and automated reporting processes
  • Design, develop, and maintain dashboards and executive reporting tools using Tableau, Power BI, or similar business intelligence platforms
  • Monitor healthcare cost trends, reimbursement performance, utilization patterns, and market benchmarks to identify strategic risks and opportunities
  • Support provider contract negotiations through financial modeling, pricing scenario analysis, and reimbursement benchmarking
  • Ensure accuracy and integrity of pricing models, reimbursement logic, and analytical reporting deliverables
  • Lead analytical initiatives focused on cost containment, network optimization, and operational performance improvement
  • Collaborate with cross-functional stakeholders to prioritize analytical initiatives and deliver actionable business insights
  • Oversee implementation and validation of fee schedule updates, reimbursement changes, and pricing configurations
  • Mentor and develop analysts while promoting best practices in analytics, reporting, and process improvement
  • Present analytical findings, strategic recommendations, and financial impacts to senior leadership and business partners

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:
  • Bachelor's degree in finance, Economics, Healthcare Administration, Business Analytics, Statistics, or related field
  • 2 + years of experience in healthcare pricing, provider reimbursement, managed care analytics, healthcare finance, or network contracting
  • 2 + years of experience leading projects, initiatives, or analytical teams
  • 2 + years advanced proficiency in Microsoft Excel, SQL, and data analysis techniques
  • Experience working with large healthcare claims datasets and relational database environments
  • Experience developing dashboards and visual reporting using Tableau, or similar tools
  • Demonstrated experience in financial modeling, trend analysis, and executive-level reporting
  • Solid understanding of healthcare reimbursement methodologies including:
    • Fee-for-service
    • Capitation
    • DRG
    • APC
    • Medicare-based reimbursement
    • Per Diem, Case Rates, Stop Loss and Percent of billed charges
    • Value-based payment methodologies
    • California Hospital Market Knowledge
  • Proven solid communication, organizational, and stakeholder management skills
  • Proven ability to manage multiple priorities and lead cross-functional initiatives

Preferred Qualifications:
  • Master's degree in business, Statistics, Healthcare Administration, Finance, Data Analytics, or related fields
  • Experience within managed care, health insurance, PPO, or provider contracting organizations
  • Experience with healthcare claims systems, contract modeling software, or reimbursement configuration platforms
  • Experience using SQL, SAS, Python, R, Snowflake, Databricks, or advanced analytical platforms
  • Experience leading reporting automation or analytical transformation initiatives
  • Knowledge of CMS reimbursement methodologies and healthcare regulatory requirements

Core Competencies
  • Healthcare pricing and reimbursement strategy
  • Financial modeling and cost trend analysis
  • Data analytics and reporting automation
  • Dashboard and business intelligence development
  • Strategic thinking and problem-solving
  • Leadership and team development
  • Cross-functional collaboration
  • Executive communication and presentation skills
  • Process improvement and operational optimization
  • Project and stakeholder management

*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 $72,800 - $130,000 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.

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