Network Pricing Consultant Telecommute

Company: UnitedHealth Group
Location: Orlando
Posted on: August 7, 2022

Job Description:

Optum is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)
The Retail Network Lease Pricing Consultant supports operations requirements and works to develop and enhance processes to create more efficient approaches towards compliance. -Retail Network Lease Pricing Consultants -conduct various pricing analysis activities in support of network contracting regulations and management strategies. Responsibilities also include managing maintenance on achieved solutions and performance metrics / reporting.
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 to discover ways to operationalize state law requirements. They also generate reports and deal with escalated complaints from states DOI and OIC.
You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Ensure all pharmacy Retail Network Lease pricing updates are handled in a timely manner
Review pharmacy pricing work performed by others and provided recommendations for improvement
Provide business rules and requirements for IT development of system tools to support new processes and/or enhancements
Collaborate with the data and reporting team to design and create various internal and external reporting
Provide business rules and requirements for IT development of system tools to support new processes and/or enhancements
Collaborate with others to develop policies and procedures and implement solutions that ensure adherence with applicable laws and regulations
Review and assess regulatory requirements applicable to business units
Understanding of Pharmacy state regulatory requirements
Prepare responses on all Pharmacy regulatory inquires and audits
Maintain proper documentation of policies and procedures, process flows, SOPs, Job Aids, etc.
Develop project plan and task level tracking to ensure on-time delivery of solutions
Solve complex problems and develop innovative solutions
Anticipate customer needs and proactively develop solutions to meet them
Provide explanations and information to others on the most complex issues
Motivate and inspire other team members

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 related experience
2+ years of experience in healthcare
2+ years of analytical experience in financial analysis, healthcare pricing, network management, healthcare economics, or related discipline
2+ years of experience in documenting policies and procedures, workflows, and tracking critical timelines
1+ years of experience working with Regulatory, Legal, Compliance or Contracting
Expert level proficiency in MS Excel (formulas, macros, pivot tables, run calculations, create pricing models, create reporting, manipulate data, etc.)
Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
Preferred Qualifications:
1+ years of experience with provider payment methodologies and healthcare products
Knowledge of MS Office -MS Access and Tableau
Intermediate Level Proficiency with SQL (pull, sort, filter and manipulate data, code, create reporting, etc.)
Flexible and able to adapt to new processes
Self-motivated, self-driven and detail-oriented
Solid written and verbal communication skills
Ability to prioritize, coordinate and manage multiple tasks in a fast-paced environment

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
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)
Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $66,100 to $118,300. The salary range for Connecticut / Nevada residents is $72,800 to $129,900. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

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.

Keywords: UnitedHealth Group, Orlando , Network Pricing Consultant Telecommute, Professions , Orlando, Florida