Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together.
As part of Optum Health's Healthcare Economics Network Strategy & Analytics Department, this role is responsible for producing high-quality analytical deliverables while helping to drive the development of standardized reporting, scalable analytic processes, and data management practices that support organizational goals. Successful candidates will demonstrate strong communication skills, intellectual curiosity, initiative, and the ability to adapt and contribute effectively in a dynamic, collaborative environment.
This role primarily supports CMS Physician repricing activity in SAS and creates dashboards in Tableau and PowerBI used by contractors for local markets. This role also validates provider and payor network contracting and trend management activities through financial or pricing modeling, negotiation support, analysis, and reporting. The team and this role manage reimbursement benchmarking, performance reporting, maintenance of associated financial models, and other responsibilities as assigned.
This role will partner closely with contracting, finance, actuarial, operations, provider relations, and executive leadership teams to evaluate pricing impacts, support provider negotiations, and drive data-informed business decisions.
Positions in this function research and investigate key business problems through quantitative analyses of utilization and healthcare costs data. Provides management with statistical findings and conclusions. Identifies potential areas for medical cost improvements and alternative pricing strategies. Provides data in support of actuarial, financial and utilization analyses.
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:
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:
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, Accountable Care activities including opportunity identification and communication.
Experience working with healthcare claims and reimbursement methodologies
Advanced proficiency working with query, business intelligence and statistical tools, include 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
Required Qualifications:
Bachelor's degree in finance, Healthcare Administration, Economics, Statistics, Mathematics, Business Analytics, or related fields
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.
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 $91,700 - $163,700 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 help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.
UnitedHealth Group and its affiliated brands are 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 and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
| Location | Richardson, TX |
| Industry | Healthcare Services |
| Salary | $91,700–$163,700 Per Year |
| Company Size | 10,000 employees or more |
| Year Founded | 1977 |
| Website | http://careers.unitedhealthgroup.com/ |
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.
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