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UnitedHealth Group Sr. Consultant, Analytic Development - Telecommute Nationwide in Minnesota

Do you love the excitement of a fast-paced, high-growth organization? If so, a career at Optum, part of the UnitedHealth Group family of businesses will allow you to serve almost all dimensions of the health system from those who diagnose and treat patients to those who pay for care, deliver health services and those who supply the cures. Optum brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. Join us and learn why there is no better place to do your life's best work. (sm)

As an Analytic Development Sr. Consultant, you will be responsible for supporting the identification, development, and presentation of new medical cost savings opportunities on behalf of our clients. This position will support the assessment of new opportunities based on data insights leveraging tools, policies, industry trends, and by soliciting input from a broad network of experts across Optum. This highly trained industry expert will work with internal and external business constituents to determine opportunities for growth within our core payment integrity businesses and be responsible for savings delivery through deployment.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

PrimaryResponsibilities:

  • Identifysavings initiatives that drive specific and measurable results, providingtimely and meaningful client updates

  • Participate in analytical,experimental, investigative and other fact-finding work in support ofconcept development

  • Establish strong relationshipswith internal and external stakeholders to define, align, and deliverpayment integrity initiatives in support of assigned clients

  • Influence senior leadership toadopt new ideas, approaches, and/or products

  • Recommend changes to currentproduct development procedures based on market research and new trends

  • Utilize data mining tools (i.e. SQL, Access,Excel) in order to analyze data to support of their hypothesis

  • Research policies, coding guidelines, andregulations that would support the hypothesis being developed

  • Develop Business Requirement Documentation ina clear, concise, and comprehensive manner

  • Clearly communicate concept to businesspartners/clients and be able to appropriately respond to questions relating tothe logic utilized within hypothesis testing, documentation, and the analytic

  • Perform quality audits for claim overpaymentresults and monitoring analytic performance

  • Provide mentorship and guidance to AnalyticDevelopment Consultants

  • Industry thought leader andpractice SME

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.

Required Qualifications:

  • BA/BSdegree or equivalent experience

  • 3+ years of experience in healthcare (billing,coding, auditing claims)

  • 2+ years of experience conducting analysis onlarge data sets

  • 1+ years of SQL experience (PLSQL, Teradata,MySQL)

  • 1+ years of experience with claims processingor adjudication systems (Such as UNET, COSMOS, Facets, Diamond, etc. or providerbilling / coding knowledge on Professional and Facility claims)

  • An understanding of healthcare paymentmethodologies, policies, and coding are necessary

  • Maintains working knowledge of codingstandards, billing rules and regulations and knowledge of procedure anddiagnosis codes (CPT, ICD10 coding, HCPCS, APC and DRGs)

  • Strong computer skills:Access, Excel, Visio, PowerPoint

  • Highly collaborative andconsultative style with ability to establish credibility quickly with alllevels of management across multiple functional areas

  • Strong project managementapproach with excellent critical thinking and problem-solving skills

  • Exceptional presentation,communication and negotiation skills

  • Ability to think outside of the box andbreakdown complex problems into individual root causes

  • Self-managed, self-starter withthe ability to support multiple concurrent projects and meet tightdelivery timelines

  • If you need to enter a work site for anyreason, you will be required to screen for symptoms using the ProtectWellmobile app, Interactive Voice Response (i.e., entering your symptoms viaphone system) or similar UnitedHealth Group-approved symptom screener.When in a UnitedHealth Group building, employees are required to wear amask in common areas. In addition, employees must comply with any stateand local masking orders

Preferred Qualifications:

  • Advanced degree in health care ormedical field

  • 5+ years' experience in the healthcare industry (Medicare, Medicaid, Commercial) with deep exposure toPayment Integrity

  • 2+ years' experience working ina matrix and highly adaptive environment handling tight deadlines

  • Coding certification through AAPCor AHIMA

  • Knowledge of statistical methodsused in the evaluation of healthcare claims data

  • Expert SQL coding skills and ability to runtest queries to ensure viability of concepts under review

Careers withOptum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy

Diversitycreates a healthier atmosphere: All qualified applicants will receiveconsideration for employment without regard to race, color, religion, sex, age,national origin, protected veteran status, disability status, sexualorientation, gender identity or expression, marital status, geneticinformation, or any other characteristic protected by law.

UnitedHealthGroup is a drug-free workplace. Candidates are required to pass a drug testbefore beginning employment.

Job Keywords: Healthcare, billing, coding, auditing claims, data analytics, SQL, PLSQL, Teradata, MySQL, UNET, COSMOS, Facets, Diamond, Medicare, Medicaid, AAPC, AHIMA, telecommute

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