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UnitedHealth Group
Consultant, Healthcare Economics & Hospital Contracting Analytics
Career Insights for Healthcare Analyst
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Based on New Mexico data
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What they do
A Healthcare Analyst is responsible for compiling important medical data through the use of computer-based applications, within a health care organization or hospital. Responsible for gathering, compiling, modeling, validating, and analyzing data needed by the organization.
$101,836 / year median in New Mexico
-1% projected decline
Job Description
- Requisition number:
- 2375254
- Job category:
- Healthcare Economics Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives.
- Caring. Connecting. Growing together.
- The Senior Healthcare Economics Consultant (Network Pricing & Analytics) is responsible for supporting provider reimbursement analysis, pricing strategy support, financial modeling, and analytical reporting activities across provider network initiatives.
- 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:
- + Lead provider reimbursement analysis, pricing model development, and financial impact assessments supporting network strategy initiatives + Manage large healthcare datasets including medical claims, reimbursement, provider, utilization, and financial performance data + Oversee development and optimization of SQL queries, analytical models, and automated reporting processes + Design, develop, and maintain dashboards and executive reporting tools using Tableau, Power BI, or similar business intelligence platforms + Monitor healthcare cost trends, reimbursement performance, utilization patterns, and market benchmarks to identify strategic risks and opportunities + Support provider contract negotiations through financial modeling, pricing scenario analysis, and reimbursement benchmarking + Ensure accuracy and integrity of pricing models, reimbursement logic, and analytical reporting deliverables + Lead analytical initiatives focused on cost containment, network optimization, and operational performance improvement + Collaborate with cross-functional stakeholders to prioritize analytical initiatives and deliver actionable business insights + Oversee implementation and validation of fee schedule updates, reimbursement changes, and pricing configurations + Mentor and develop analysts while promoting best practices in analytics, reporting, and process improvement + Present analytical findings, strategic recommendations, and financial impacts to senior leadership and business partners 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:
- + Bachelor's degree in finance, Economics, Healthcare Administration, Business Analytics, Statistics, or related field + 2 + years of experience in healthcare pricing, provider reimbursement, managed care analytics, healthcare finance, or network contracting + 2 + years of experience leading projects, initiatives, or analytical teams + 2 + years advanced proficiency in Microsoft Excel, SQL, and data analysis techniques + Experience working with large healthcare claims datasets and relational database environments + Experience developing dashboards and visual reporting using Tableau, or similar tools + Demonstrated experience in financial modeling, trend analysis, and executive-level reporting + Solid understanding of healthcare reimbursement methodologies including: + Fee-for-service + Capitation + DRG + APC + Medicare-based reimbursement + Per Diem, Case Rates, Stop Loss and Percent of billed charges + Value-based payment methodologies + California Hospital Market Knowledge + Proven solid communication, organizational, and stakeholder management skills + Proven ability to manage multiple priorities and lead cross-functional initiatives •
Preferred Qualifications:
- + Master's degree in business, Statistics, Healthcare Administration, Finance, Data Analytics, or related fields + Experience within managed care, health insurance, PPO, or provider contracting organizations + Experience with healthcare claims systems, contract modeling software, or reimbursement configuration platforms + Experience using SQL, SAS, Python, R, Snowflake, Databricks, or advanced analytical platforms + Experience leading reporting automation or analytical transformation initiatives + Knowledge of CMS reimbursement methodologies and healthcare regulatory requirements •Core Competencies•+ Healthcare pricing and reimbursement strategy + Financial modeling and cost trend analysis + Data analytics and reporting automation + Dashboard and business intelligence development + Strategic thinking and problem-solving + Leadership and team development + Cross-functional collaboration + Executive communication and presentation skills + Process improvement and operational optimization + Project and stakeholder management •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.
Application Deadline:
- This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected.