Senior Healthcare Economic Consultant - Remote

Overview

This role supports healthcare economics, including the design and development of standard analytics deliverables, refined processes for scaling analytics across markets, and data organization aligned to business goals. It also validates provider and payor network contracting and trend management activities through financial or pricing modeling, analysis, and reporting.

The position partners with contracting, finance, actuarial, operations, provider relations, and executive leadership to evaluate pricing impacts, support provider negotiations, and drive data-informed business decisions.

Responsibilities

• Design and implement tools using programming languages, BI tools, and other resources to identify health care cost and revenue drivers by market segment and/or provider/payor, referral patterns, and reimbursement rates
• Develop SQL queries, analytical models, dashboards, and automated reporting tools to support executive decision-making
• Perform 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 cost containment, network optimization, and operational performance improvement initiatives with cross-functional stakeholders
• Present analytical findings and strategic recommendations to leadership; build partnerships across contracting, finance, actuarial, and market teams
• Standardize and document repeatable processes to promote best practices and scalability
• Research and investigate key business problems through quantitative analyses of utilization and healthcare cost data, providing statistical findings and conclusions
• Identify potential areas for medical cost improvements and alternative pricing strategies
• Review the work of others, develop innovative approaches, serve as an expert, and support leadership and mentoring

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 (pivot tables, formulas, and financial modeling)
• Intermediate or greater proficiency in MS-SQL (use and edit existing queries; create new queries, including joins and case statements)
• Strong 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

Compensation & Benefits

• Salary range: $91,700 - $163,700 annually (based on full-time employment)
• Pay is based on factors including, but not limited to, local labor markets, education, work experience, certifications, etc.
• Benefits may include a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements)

Location

• Remote work: within the U.S.
• For hires in the Minneapolis or Washington, D.C. area: required to work in the office a minimum of four days per week

Additional Information

• Employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
• Application will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected; the posting may come down early due to volume of applicants.
• The employer is a drug-free workplace; candidates are required to pass a drug test before beginning employment.