Leads healthcare network pricing and financial analysis, including provider contract valuation, unit cost modeling, budget management, forecasting, performance reporting, and negotiation support. Develops analytical approaches to improve pricing accuracy, evaluates financial impacts of contract changes, manages cross-functional initiatives, provides subject-matter expertise, reviews analyses, and mentors colleagues.
Requisition Number: 2394401
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.
Can we all agree that the quality of health care is marching forward and upward with great momentum? Yes. But it's not just quality of care. The entire system is becoming more efficient and effective thanks to companies like UnitedHealth Group and people like you. Here's your opportunity to use your expertise in new ways as you strike the balance between health care costs and resources. Performing unit cost and contract valuation analysis, you'll ensure that healthcare contracts are priced accurately and fairly for all involved. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 6 leader.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
This opportunity is all about complexity. You're expected to help accurately and effectively price the network. It's challenging because you need to be creative in the analytics behind the contract to utilize resources to build the data and price the network accurately.
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:
Preferred Qualifications:
*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 $xx,xxx to $xx,xxx 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 help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.
UnitedHealth Group and its affiliated brands are 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 and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.
Can we all agree that the quality of health care is marching forward and upward with great momentum? Yes. But it's not just quality of care. The entire system is becoming more efficient and effective thanks to companies like UnitedHealth Group and people like you. Here's your opportunity to use your expertise in new ways as you strike the balance between health care costs and resources. Performing unit cost and contract valuation analysis, you'll ensure that healthcare contracts are priced accurately and fairly for all involved. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 6 leader.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Strategic Leadership and Innovation
- Anticipate emerging customer needs and develop innovative solutions to address them
- Contribute to the development of business strategy
- Influence senior leadership to adopt new ideas, products, and approaches
- Lead cross-functional and cross-segment teams
- Serve as a trusted subject-matter expert
- Provide leadership and mentorship to colleagues
- Financial Analysis and Network Pricing
- Support and validate provider network contracting and unit cost management activities across physicians, hospitals, pharmacies, ancillary facilities, and other provider types through financial and network pricing modeling, analysis, and reporting
- Conduct unit cost and contract valuation analyses to support network contracting negotiations and unit cost management strategies
- Manage unit cost budgets, target setting, performance reporting, and related financial models
- Develop innovative analytical approaches to improve pricing accuracy and business outcomes
- Review the work of others and recommend improvements
This opportunity is all about complexity. You're expected to help accurately and effectively price the network. It's challenging because you need to be creative in the analytics behind the contract to utilize resources to build the data and price the network accurately.
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:
- 5+ years of analytical experience in financial analysis, health care pricing, network management, healthcare economics or related discipline
- 5+ years of experience with provider payment methodologies and health care products
- 5+ years of experience in creating and using financial modeling tools, spreadsheets and information acquisition tools
- Experience in interpreting and reviewing financial modeling results to evaluate the financial impact of contract changes and develop forecasts
- Expertise in financial impact analysis, risk management and data manipulation
- Expert level proficiency in MS Excel
Preferred Qualifications:
- Experience with medical coding (CPT, ICD-9, ICD-10, etc.)
- Knowledge of MS Access
*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 $xx,xxx to $xx,xxx 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 help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.
UnitedHealth Group and its affiliated brands are 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 and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Similar Jobs at Optum
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
Conduct inpatient acute-care and length-of-stay medical necessity reviews using evidence-based guidelines. Collaborate telephonically with treating providers on care plans, quality gaps, and healthcare expenses. Partner with operational and business teams on clinical and quality initiatives, participate in market oversight meetings, and provide utilization management leadership. The role requires an active Missouri medical license, board certification, clinical experience, remote work capability, and rotational holiday and call coverage.
Top Skills:
Computer Software And SystemsEvidence-Based Medicine (Ebm)High-Speed InternetInterqual Care Guidelines
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
Provides telehealth psychiatric evaluations, diagnoses, treatment, medication management, stabilization, and follow-up for patients with serious mental illness and substance use disorders. Collaborates with interdisciplinary teams, coordinates community and specialty behavioral health services, provides consultation and education, triages patients, participates in care planning and quality improvement, and documents encounters in the EMR. Missouri licensure enables remote work, with willingness to obtain multistate licensure required.
Top Skills:
EmrTelehealth
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
Reviews initial and continued ABA treatment requests for commercial and Medicaid plans. Applies clinical criteria, benefit requirements, and applicable regulations; conducts peer-to-peer consultations; issues clinical and adverse benefit determinations; reviews appeals and single-case agreements; and collaborates with clinical teams and providers.
Top Skills:
Broadband InternetMicrosoft AccessExcelMicrosoft Office Suite
What you need to know about the Los Angeles Tech Scene
Los Angeles is a global leader in entertainment, so it’s no surprise that many of the biggest players in streaming, digital media and game development call the city home. But the city boasts plenty of non-entertainment innovation as well, with tech companies spanning verticals like AI, fintech, e-commerce and biotech. With major universities like Caltech, UCLA, USC and the nearby UC Irvine, the city has a steady supply of top-flight tech and engineering talent — not counting the graduates flocking to Los Angeles from across the world to enjoy its beaches, culture and year-round temperate climate.
Key Facts About Los Angeles Tech
- Number of Tech Workers: 375,800; 5.5% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Snap, Netflix, SpaceX, Disney, Google
- Key Industries: Artificial intelligence, adtech, media, software, game development
- Funding Landscape: $11.6 billion in venture capital funding in 2024 (Pitchbook)
- Notable Investors: Strong Ventures, Fifth Wall, Upfront Ventures, Mucker Capital, Kittyhawk Ventures
- Research Centers and Universities: California Institute of Technology, UCLA, University of Southern California, UC Irvine, Pepperdine, California Institute for Immunology and Immunotherapy, Center for Quantum Science and Engineering
