Director Of Claims Pricing Solutions - Remote

UnitedHealth Group Inc.

Hartford, CT(remote)

JOB DETAILS
SALARY
$134,600–$230,800 Per Year
SKILLS
Analysis Skills, Artificial Intelligence (AI), Budgeting, Business Support, Communication Skills, Competitive Analysis/Strategy, Contract Analysis, Contract Management, Contract Review, Cost Control, Cross-Functional, Customer/Client Research, Develop and Maintain Customers, Documentation, Emerging Technology, Epic Tapestry, Establish Priorities, Facilities Planning, Finance, Forecasting, Health Plan, Healthcare, Leadership, Marketing, Medicaid, Medicare Reimbursement, Negotiation Skills, Presentation/Verbal Skills, Pricing, Pricing Software, Problem Solving Skills, Product Pricing, Product Support, Product/Service Launch, Project/Program Management, Regulatory Compliance, Reimbursement, Revenue Growth, Risk Management, Sales, Sales Management, Sales Presentation, Sales Proposals, Systems Administration/Management, Team Lead/Manager, Trend Analysis, Work From Home, Writing Skills
LOCATION
Hartford, CT
POSTED
4 days ago

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.

The Director of Claims Pricing Solutions will serve as the subject matter expert within the Optum Go to Market organization. The role involves collaborating with market, growth, operations, marketing, finance, pricing, and product teams to support growth and renewal strategies for Optum's Payment claims pricing software and services portfolio. Key responsibilities include developing and presenting client-specific solutions, managing stakeholders through the contract lifecycle, demonstrating claims pricing software, and ensuring proposals include the correct solution mix, pricing approach, and value story. Additionally, the role involves providing voice-of-customer feedback, reviewing new solution concepts, identifying target customers, and helping launch new products to the market.

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:

  • Collaborating with internal cross-functional teams, including internal market, growth, operations, and product teams; and external business partners to support growth and renewal strategies for Optum's Payment claims pricing software and services portfolio
  • Developing and presenting client-specific presentations, software solutions, managing stakeholders through the contract lifecycle, and ensuring proposals include the correct solution mix, pricing approach, contract terms, and value story
  • Providing voice-of-customer feedback, reviewing new solution concepts, identifying target customers, and helping launch new products to the market
  • Presenting Optum's full pricing software capabilities
  • Applying advanced analytical and quantitative approaches to problem-solving for large complex clients with multiple lines of business and/or products and/or new-to-market solutions
  • Using communication skills to influence and negotiate
  • Working directly with customers to define other new pricing needs and requirements
  • Supporting Optum Business Partners with questions around integration
  • Compiling documentation: processes and procedures (including but not limited to client or system-specific tracking)
  • Prioritizing projects and outcomes identified by the Executive Team
  • Providing insight related to savings targets, budget and forecasting, and increased medical and administrative savings opportunities
  • Driving execution on new sales opportunities and developing new pricing models for emerging products and content, including sales presentations, RFP responses, and providing expertise in pricing new deals and renewals as well as more complex vendor and tri-party agreements
  • Ensuring that contracts are reviewed and represent the best interest of the business

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:

  • 8+ years of claims pricing experience
  • Experience translating, configuring, and testing pricing terms into a contract management software tool
  • Experience with facility and professional contracting and reimbursement across Medicare, Medicaid, and Commercial
  • Health plan experience in facility contract configuration, claims, network contracting or a technology division
  • Claims system and/or contract modeling experience with at least of one of the following: Cognizant: Facets/NetworX, QNXT/NetworX; HealthEdge: Health Rules Payer; Advantasure: iKA Claims; Epic: Tapestry; 3M: GPCS; RAM: HealthSuite; and/or Conduent/HSP: MediTrac; HealthEdge Source; Zelis: Payer Compass; Reimbursement Manager (REM); PMMC: Contract Modeling; Strata: Market Reimbursement Intelligence or Contract Analytics; MD Clarity: RevFind or Clarity Flow; ClaraPrice: Payer Contract Management
  • Proven excellent verbal and written communication skills. Ability to influence and negotiate effectively

Preferred Qualifications:

  • 10+ years of claims pricing experience
  • Experience using Optum pricing tools: Rate Manager, Payment System Interface, and/Reimbursement Manager
  • Experience documenting client operational, pricing, and technical workflows
  • Account management experience
  • Project management experience
  • Proven experience in leading cross-functional teams and managing large-scale projects
  • Knowledge of emerging trends and technologies (AI) in healthcare
  • Understanding of healthcare industry regulations and compliance requirements
  • Proven track record in managing executive initiatives and driving strategic projects
  • 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 $134,600 - $230,800 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 make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is 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 is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

About the Company

U

UnitedHealth Group Inc.

UnitedHealth Group is a health care and well-being company that’s dedicated to improving the health outcomes of millions worldwide. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others.

What we do

Gain insights on how we work to help people live healthier lives and help make the health system work better for everyone by watching this video.

https://www.youtube.com/watch?v=5PbNyi2IDkY

Caring. Connecting. Growing together.

Being a part of UnitedHealth Group means working to improve health outcomes for everyone, including yourself. Here is how:

Caring. Your total health and well-being are important to us. Whatever matters most to you — we have resources to help you be your best at work and at home. The benefits range from free Peloton courses to financial counseling. Learn more about what we offer.

Connecting. We recognize our collective power to make an impact across our communities because we believe the health of any society is measured by the overall health of its people. Learn more about our culture.

Growing together. UnitedHealth Group is full of inspiring career stories, and we offer a lifetime of opportunities. Discover all the ways you can learn, grow and develop.

COMPANY SIZE
10,000 employees or more
INDUSTRY
Healthcare Services
FOUNDED
1977
WEBSITE
http://careers.unitedhealthgroup.com/