Healthcare Economics Consultant - Remote

Improve the lives of others while Caring. Connecting. Growing together.

Job Description
- Healthcare Economics Consultant
- Remote (2368110)

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.

This role within Optum Health’s Healthcare Economics Network Strategy & Analytics Department Candidate is responsible for producing their own quality work product but also supports the design & development of new standard work products, refined processes for scaling analytics across markets, and overall data organization that supports our business goals. Candidates should have strong verbal skills, strong written communication skills and demonstrate self-motivation, initiative, and adaptability in a dynamic environment.

This role primarily supports and validates provider and payor network contracting and trend management activities through financial or pricing modeling, negotiation support, analysis, and reporting. The team and this role manage unit cost budgets, reimbursement benchmarking, target setting, performance reporting, maintenance of associated financial models, and other responsibilities as assigned.

This role will partner closely with contracting, finance, actuarial, operations, provider relations, and executive leadership teams to evaluate pricing impacts, support provider negotiations, and drive data-informed business decisions. This role also provides leadership and mentorship to analytical staff while advancing reporting automation, analytical capabilities, and operational efficiencies.

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 analysis, pricing model development, and financial impact assessments to support network strategy and contract negotiations
• Manage unit cost tracking and UCRT entries, ensuring alignment with anticipated negotiation outcomes and reimbursement changes
• Analyze large healthcare datasets and monitor cost, utilization, reimbursement, and market trends to identify risks and opportunities
• Involved with the development of SQL queries, analytical models, dashboards, and automated reporting tools to support executive decision-making
• Ensure pricing, reimbursement, and reporting methodologies are accurate, consistent, statistically sound, and transparent
• Support initiatives focused on cost containment, network optimization, and operational performance improvement in collaboration with cross-functional stakeholders
• Present analytical findings and strategic recommendations to leadership and build strong partnerships across contracting, finance, actuarial, and market teams
• Standardize and document repeatable processes while mentoring and developing analysts to promote best practices and scalability

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
• Experience working with healthcare claims and reimbursement methodologies
• Knowledge of healthcare payment methodologies including:
  • Fee-for-service
  • DRG
  • APC
  • Percent of billed charges
  • Medicare-based reimbursement
  • Value-based payment models
• Advanced proficiency in Microsoft Excel, including pivot tables, formulas, and financial modeling
• Proven solid analytical and quantitative problem-solving skills
• Proven ability to work collaboratively across cross-functional teams.

• Experience in managed care, health insurance, PPO networks, or provider contracting environments
• Experience with claims systems, contract modeling software, or reimbursement configuration platforms
• Experience using SQL, Alteryx, Snowflake, or any advanced analytical platforms
• Knowledge of CMS reimbursement methodologies and regulatory guidelines
• Familiarity with actuarial or healthcare financial analysis concepts
• Proven solid attention to detail and ability to manage multiple priorities
• Proven effective written and verbal…