We all can agree that the quality of health care is marching forward and upward with great momentum. But it's not just quality of care. The entire system is becoming more efficient and effective thanks to companies like UnitedHealth Group and people like you. 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 6 leader. Primary Responsibilities: Analyze and re-price existing client claims data to support client specific analytics using SQL server, Netezza and SAS models and queriesPrepare requisite competitive (i.e., external) and internal historical claims data for use in the development of RFP response submission activities Utilize relational database tools to re-price/trial adjudicate pharmacy claims Validate source data and interpret/QA re-price/trial adjudication and summary and detail report resultsAnalyze source historical claims data for anomalies and/or trends in drug utilization patterns and costsDevelop and/or analyze and refine existing analytical models, and database queries as appropriateConduct financial and network pricing modeling, analysis and reporting This opportunity is all about complexity. A dynamic marketplace means that unit cost forecasting will always be a challenge as costs continue to change. You'll be expected to monitor, analyze and incorporate those changes in reporting packages and relay them through finance to pricing and underwriting.
Required Qualifications:3+ years of analytical experience in data analysis, health care pricing, network management, healthcare economics or related discipline2+ years of experience with provider payment methodologies and health care productsIntermediate level of proficiency in MS ExcelIntermediate level of proficiency in SQL Preferred Qualifications:Undergraduate degreePBM experienceCareers 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) 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. Job Keywords: data analysis, pricing, pharmacy, claims, models, provider, SQL, Excel, PBM, Rockville, MD, Maryland, Irvine, CA, California
Internal Number: 755182
About UnitedHealth Group
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.