Sr. Healthcare Consultant, Physician Medicare and Analytics - Remote

Overview

This role supports the Healthcare Economics Network Strategy & Analytics team and focuses on producing high-quality analytical deliverables. It contributes to standardized reporting, scalable analytic processes, and data management practices that support organizational goals.

The position primarily supports CMS Physician repricing activity in SAS and creates dashboards in Tableau and Power BI used by contractors for local markets. It also validates provider and payor network contracting and trend management activities through financial or pricing modeling, negotiation support, analysis, and reporting. Responsibilities include reimbursement benchmarking, performance reporting, maintenance of associated financial models, and other assigned duties.

Responsibilities

• Analyze large healthcare datasets using SAS and monitor cost, utilization, reimbursement, and market trends to identify risks and opportunities
• Develop and maintain interactive Tableau and Power BI dashboards using repricing outputs to support network strategy, contracting initiatives, and business decision-making
• Ensure pricing, reimbursement, and reporting methodologies are accurate, consistent, statistically sound, and transparent
• Conduct provider reimbursement analysis, support pricing model development, and perform financial impact assessments to support network strategy and contract negotiations
• Design and implement tools using programming languages, BI tools (Tableau, Power BI), and other resources to identify health care cost and revenue drivers by market segment and/or provider/payor, referral patterns, and reimbursement rates
• Create and support SQL queries, analytical models, dashboards, and automated reporting tools for executive decision-making
• 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 strong partnerships across contracting, finance, actuarial, and market teams
• Standardize and document repeatable processes to promote best practices and scalability

Required Qualifications

• Undergraduate degree or equivalent experience
• 3+ years of experience in healthcare finance, network analytics, and performing analysis on large sets of facility and professional claim data for a payer/health plan or provider/care delivery system
• 3+ years of experience working with methodology of FFS, Shared Risk and Savings models, and Accountable Care activities, including opportunity identification and communication
• Experience working with healthcare claims and reimbursement methodologies
• Advanced proficiency with SAS, SQL, Tableau, and Power BI
• Advanced proficiency in Microsoft Excel, including pivot tables, formulas, and financial modeling
• 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

• 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 multiple factors, including local labor markets, education, work experience, certifications, etc.
• Benefits include a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (eligibility requirements apply)
• Salary and benefits are subject to applicable laws; the employer complies with all minimum wage laws as applicable

Location & Work Schedule

• Remote work is available from anywhere within the U.S.
• For all hires in the Minneapolis or Washington, D.C. area: work in the office a minimum of four days per week.
• All employees working remotely will be required to adhere to the UnitedHealth Group's Telecommuter Policy.

Application

• Application deadline: This posting will remain up for a minimum of 2 business days or until a sufficient candidate pool has been collected; it may come down early due to volume of applicants.