Remote Senior Network Pricing Analyst

Optum; Eden Prairie (MN); Remote; USD 60,000 - 107,000; Full time

Job summary

UnitedHealth Group is seeking a Senior Network Pricing Consultant to analyze and re-price pharmacy claims, leveraging SQL-based data analytics to support pricing decisions and RFPs. This role involves collaborating with finance, accounting, and sales to ensure accurate claim processing and compliant pricing models.

Remote-friendly role across the U.S. with opportunities for growth and development in a diverse, inclusive environment, focusing on health equity and data-driven insights.

Qualifications

• 2+ years of analytical experience in financial analysis, PBM healthcare pricing, Network pricing or related discipline.
• 2+ years of experience with SQL Server or other relational database solutions.
• 2+ years of experience in writing Complex SQL/PLSQL queries for data analysis and reconciliation.
• 2+ years of Analytical experience in data analysis.
• Advanced level of proficiency in MS Excel.

Responsibilities

• Analyze and re-price existing client claims data to support client-specific data analytics using SQL server database.
• Prepare competitive external and internal historical claims data for use in the development of RFP response submission activities.
• Use relational database tools to re-price/trial adjudicate pharmacy claims.
• Validate source data and interpret re-price/QA/trial adjudication and summary and detail report results.
• Analyze source historical claims data for anomalies and/or trends in drug utilization patterns and costs.
• Develop and/or analyze and refine existing analytical models and database queries as appropriate.
• Conduct financial and network pricing modeling, analysis, and reporting.
• Work closely with internal teams, including finance, Accounting, and Sales, to ensure accurate and efficient claim processing.
• Keep detailed records of all pricing adjustments and ensure compliance with all relevant regulations and policies.

Skills

SQL

Complex SQL/PLSQL

MS Excel

Data analysis

Pricing analytics

Tools

SQL Server

Job description

UnitedHealth Group is seeking a Senior Network Pricing Consultant to analyze and re-price pharmacy claims, leveraging SQL-based data analytics to support pricing decisions and RFPs. This role involves collaborating with finance, accounting, and sales to ensure accurate claim processing and compliant pricing models.

Remote-friendly role across the U.S. with opportunities for growth and development in a diverse, inclusive environment, focusing on health equity and data-driven insights.