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Re-Pricing Analyst - Rockville, MD or Irvine, CA

UnitedHealth Group

Rockville, MD
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Job Details

755182 RePricing Analyst Rockville MD or Irvine CA

Re-Pricing Analyst - Rockville, MD or Irvine, CA (755182)

Position Description

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 queries

  • Prepare 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 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

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 discipline

  • 2+ years of experience with provider payment methodologies and health care products

  • Intermediate level of proficiency in MS Excel

  • Intermediate level of proficiency in SQL

Preferred Qualifications:

  • Undergraduate degree

  • PBM experience

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)



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


Job Details

  • Contest Number755182
  • Job TitleRe-Pricing Analyst - Rockville, MD or Irvine, CA
  • Job FamilyNetwork Contracting and Pricing
  • Business SegmentOptumRx

Job Location Information

  • Rockville, MD
    United States
    North America
  • Other LocationsIrvine, CA

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionNo
  • Overtime StatusExempt

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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