Healthcare Economics Consultant (Remote)

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 to start Caring. Connecting. Growing together. The Healthcare Economics Consultant (Network Pricing & Analytics) is responsible for supporting the development, analysis, implementation, and maintenance of provider reimbursement and network pricing strategies. This role analyzes healthcare claims, reimbursement methodologies, contractual terms, and market trends to support competitive and financially sustainable provider network arrangements. The analyst partners with contracting, clinical, finance, actuarial, operations, and provider relations teams to evaluate pricing impacts, support negotiations, and ensure accurate configuration and implementation of reimbursement models. 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.

Analyze provider reimbursement arrangements, fee schedules, and network pricing models. Manage unit cost entry into UCRT Support development and maintenance of pricing methodologies for professional, facility, ancillary, and value-based reimbursement arrangements Perform financial modeling and impact analysis related to provider contracts and network initiatives Evaluate claims utilization, unit cost trends, and reimbursement performance metrics Prepare pricing analyses and recommendations to support provider negotiations and strategic initiatives Validate pricing configurations and reimbursement logic within claims and contract management systems Collaborate with clinical, contracting and provider relations teams to model proposed contract terms and rate changes Monitor network performance and identify opportunities for cost savings and operational improvements Develop recurring and ad hoc reports, dashboards, and presentations for leadership and business stakeholders Ensure pricing compliance with regulatory requirements, internal policies, and contractual obligations Assist in implementation and testing of reimbursement changes and fee schedule updates Support data integrity and troubleshooting activities related to pricing and claims reimbursement 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.

Bachelor's degree in finance, Healthcare Administration, Economics, Statistics, Mathematics, Business Analytics, or related field 2+ years of analytical experience in healthcare pricing, managed care, provider reimbursement, network contracting, finance, or healthcare analytics 2 + years of experience working with healthcare claims and reimbursement methodologies 2+ years of strong analytical and quantitative problem-solving skills 2 + years of knowledge of healthcare payment methodologies include: Fee-for-service Capitation Reimbursement Case Rates Percent of billed charges Medicare-based reimbursement Value-based payment models Proven solid advanced proficiency in Microsoft Excel, including Power Pivot, formulas, and financial modeling Proven solid attention to detail and ability to manage multiple priorities Proven effective written and verbal communication skills Proven ability to work collaboratively across cross-functional teams Preferred