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UnitedHealth Group is hiring an

Actuarial Consultant (Network Pricing)

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

The successful candidate supports and validates Provider Network (physicians, hospitals, pharmacies, ancillary facilities, shared/full risk delegation, etc.) contracting and unit cost management activities through financial modeling, analysis of utilization, and reporting. They will also conduct unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies. Other duties include managing unit cost budgets, target setting, performance reporting, and being responsible for related financial models. This position will primarily support the Southeast Region markets and is likely to be a telecommute arrangement.

Challenge can often be its own reward. But why settle for just being challenged when you can also be nurtured, mentored, and supported in building an impact and fast-paced career? With UnitedHealth Group you can have all of the above, every day. Here's your opportunity to combine expertise and compassion in new ways as you strike the balance between health care costs and resources. In this role, you'll ensure that health care contracts are priced accurately and fairly for all involved. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 7 leader. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Support network pricing strategies and tactics, in collaboration with local network field leaders and network managers
  • Analyze financial impact of provider contracts (e.g., facility; physician; ancillary)
  • Analyze payment appendices to provide options for various contracting approaches and methodologies
  • Communicate results of financial impact and analysis to appropriate stakeholder groups (e.g., Network Management, Network Pricing leadership)
  • Effectively summarize information while providing supporting data to a variety of audiences
  • Conduct financial and network pricing modeling, analysis and reporting
  • Peer review the analytical models of others
  • Perform unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies
  • Influence pricing strategies and rate development by highlighting opportunities for improvement or protecting favorable rate structures
  • Strategize with network management to create optimal contracts
  • Review competitive analysis to identify appropriate pricing rates for providers
  • Perform various ad hoc projects in a timely and accurate manner
  • Demonstrate a customer service mindset

Required Qualifications:

  • Undergraduate degree in Math, Statistics, Finance, Economics or related field of study
  • 4+ years of analytical experience in financial analysis, healthcare pricing, network pricing, healthcare economics or related discipline
  • Presentation experience to internal or external stakeholders or customers
  • Familiarity with interpreting and reviewing financial modeling results to evaluate the financial impact of contract changes and developing forecasts
  • Advanced level of proficiency in Microsoft Excel
  • Proven ability to manage multiple projects simultaneously and meet deliverable deadlines
  • Proven ability to research and solve problems independently
  • Proven excellent financial impact analysis, risk management, and data manipulation skills
  • Proven excellent interpersonal, collaboration, negotiation, and communication skills

Preferred Qualifications:

  • Postgraduate degree in Math, Statistics, Finance, Economics or Actuarial Science
  • 3+ years of experience with provider payment methodologies and healthcare products
  • Experience with MS Access, SAS and/or SQL
  • Experience with advanced statistical functions for financial modeling
  • Experience with medical coding (CPT, MSDRG, REV, ICD-10, etc.)
  • Knowledge of Commercial, Medicare, and Medicaid PPO and HMO revenue and expense, as well as delegation financial modeling

The salary range for this role is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

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.

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.

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