Senior Healthcare Economic Consultant - Remote

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 in making healthcare work better for everyone through people-led, responsible AI while 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 solid verbal skills, solid 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 Responsibilities

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 solid 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 Qualifications

• 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

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
• 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)
• Demonstrated solid attention to detail and ability to manage multiple priorities
• Demonstrated solid analytical and quantitative problem-solving skills
• Proven effective written and verbal communication skills
• Proven ability to work collaboratively across cross-functional teams

Preferred Qualifications

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 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.