Senior Healthcare Economic Consultant - Remote

Overview

This role supports healthcare economics and network strategy/analytics efforts by producing quality analytical work products and contributing to the design and development of standard work products, refined processes for scaling analytics across markets, and overall data organization that supports business goals.

Primary focus includes supporting and validating provider and payor network contracting and trend management through financial or pricing modeling, negotiation support, analysis, and reporting. The work involves managing unit cost budgets, reimbursement benchmarking, target setting, performance reporting, maintenance of associated financial models, and other assigned responsibilities.

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

Responsibilities

• Design and implement sound tools using programming languages, BI tools, and other resources to identify principal healthcare 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
• Conduct provider reimbursement analysis, support pricing model development, and perform financial impact assessments to inform network strategy and contract negotiations
• Track unit costs and manage UCRT entries, ensuring alignment with anticipated negotiation outcomes and reimbursement changes
• Analyze large healthcare datasets to monitor cost, utilization, reimbursement, and market trends, identifying risks and opportunities
• Ensure pricing, reimbursement, and reporting methodologies are accurate, consistent, statistically sound, and transparent
• Collaborate with cross-functional stakeholders on initiatives focused on cost containment, network optimization, and operational performance improvement
• Present analytical findings and strategic recommendations to leadership and build partnerships across contracting, finance, actuarial, and market teams
• Standardize and document repeatable processes to promote best practices and scalability
• Review the work of others, develop innovative approaches, and serve as an expert/leader/mentor

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
• 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)
• 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
• Proven solid attention to detail and ability to manage multiple priorities
• Proven 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

Compensation & Benefits

• Salary range: $91,700 - $163,700 annually (based on full-time employment)
• Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc.
• Benefits 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 is available from anywhere within the U.S.
• For 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.

Additional Information

• 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.
• Drug-free workplace: candidates are required to pass a drug test before beginning employment.
• Equal Employment Opportunity employer under applicable law; qualified applicants will receive consideration without regard to protected characteristics as defined by local, state, or federal laws, rules, or regulations.