Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm) The Network Pricing Consultant supports and validates Provider Network ( pharmacies) contracting and unit cost management activities through financial and network pricing modeling, analysis, and reporting. Network Pricing Consultants conduct unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies. Responsibilities also include managing unit cost budgets, target setting, performance reporting, and associated financial models. This team is responsible for making sure that we are complaint with state MAC laws regarding pricing and appeals. They meet with the Regulatory Department and find ways to operationalize state law requirements. They also generate reports and deal with escalated complaints from states DOI. Primary Responsibilities:Anticipate customer needs and proactively develop solutions to meet them Serve as a key resource on complex and / or critical issues Solve complex problems and develop innovative solutions Perform complex conceptual analyses Review work performed by others and provide recommendations for improvement Forecast and plan resource requirements Authorize deviations from standards May lead functional or segment teams or projects Provide explanations and information to others on the most complex issues Motivate and inspire other team members
Required Qualifications:Undergraduate degree 5+ years of analytical experience in financial analysis, healthcare pricing, network management, healthcare economics, or related discipline 3+ years of experience with provider payment methodologies and healthcare products At least an intermediate level of proficiency in performing financial impact analysis, risk management, and data manipulation 2+ years of experience in creating and using financial modeling tools, spreadsheets, and information acquisition tools including experience in interpreting and reviewing financial modeling results to evaluate the financial impact of contract changes and develop forecasts Strong written and verbal communication skills Expert level proficiency in MS Excel Careers with OptumRx. We're one of the largest and most innovative pharmacy benefits managers in the US, serving more than 12 million people nationwide. Here you'll fill far more than prescriptions. As a member of one of our pharmacy teams, you're empowered to be your best and do whatever it takes to help each customer. You'll find unrivaled support and training as well as a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us. There's no better place to help people live healthier lives while doing your life's best work.(sm) Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: Pricing, Network Management, Healthcare economics, Irvine, CA, California, Schaumburg, IL, Illinois, Minnesota
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.