Senior Network Pricing Consultant - Remote CST/EST preferred

Requisition Number: 2353073
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 to start Caring. Connecting. Growing together.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:

• Own and maintain Out of Network and hospital based physician pricing models, ensuring accuracy, consistency, and compliance with Federal No Surprises Act and state Surprise Medical Bill regulations
• Apply deep knowledge of OON and surprise billing programs to support pricing strategy and dispute resolution initiatives
• Perform complex financial and pricing analyses to evaluate reimbursement strategies and network configurations across hospital, ancillary, and physician provider types
• Develop, enhance, and maintain analytical and financial models, including SQL based reporting and advanced Excel formulas/macros
• Independently produce ad hoc analyses and customized reports to support enterprise and pricing needs, including provider terminations
• Partner cross functionally to prepare insights, research, and data driven talking points that inform pricing and network strategy decisions
• Serve as a subject matter expert for network pricing, confidently presenting findings, resolving model issues, and translating complex analysis into concise recommendations for leadership

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 or equivalent relevant work experience
• 5+ years of experience in healthcare pricing, financial analysis, network pricing, or healthcare economics
• Experience developing and interpreting financial and pricing models to support contract valuation and network strategy
• Advanced Excel skills with demonstrated ability to analyze large, complex datasets efficiently
• Working experience with SQL to support ad hoc analysis and reporting
• Solid communication skills with experience presenting complex analytical findings to stakeholders
• Proven ability to manage multiple priorities and deliver results in a fast paced environment
• Ability to work Central or Eastern Time Zone hours

Preferred Qualifications:

• Experience with provider payment methodologies, including physician, hospital, and ancillary reimbursement
• Experience with PPM (Physician Pricing Model) and UCRT (Unit Cost Reporting Tool)
• Experience leveraging enterprise approved automation or AI tools to improve efficiency in analytical workflows
• Knowledge of Out of Network pricing, surprise billing regulations, and medical coding (e.g., CPT, DRG, ICD 10)
• Proficiency with advanced data modeling tools (e.g., Power Pivot, data models, large databases)
• Solid consultative, problem solving, and cross functional collaboration skills

*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 to $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.