Senior Consultant Analytic Development - Remote - 2173965I

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Job Code
2173965I
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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
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.
Youll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Identify savings initiatives that drive specific and measurable results, providing timely and meaningful client updates
Participate in analytical, experimental, investigative and other fact-finding work in support of concept development
Establish solid relationships with internal and external stakeholders to define, align, and deliver payment integrity initiatives in support of assigned clients
Influence senior leadership to adopt new ideas, approaches, and/or products
Recommend changes to current product 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, and regulations that would support the hypothesis being developed
Develop Business Requirement Documentation in a clear, concise, and comprehensive manner
Clearly communicate concept to business partners/clients and be able to appropriately respond to questions relating to the logic utilized within hypothesis testing, documentation, and the analytic
Perform quality audits for claim overpayment results and monitoring analytic performance
Provide mentorship and guidance to Analytic Development Consultants
Industry thought leader and practice SME
Youll 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/BS degree or equivalent experience
3 years of experience in healthcare (billing, coding, auditing claims)
2 years of experience conducting analysis on large data sets
1 years of SQL experience (PLSQL, Teradata, MySQL)
1 years of experience with claims processing or adjudication systems (Such as UNET, COSMOS, Facets, Diamond, etc. or provider billing / coding knowledge on Professional and Facility claims)
Understanding of healthcare payment methodologies, policies, and coding are necessary
Maintains working knowledge of coding standards, billing rules and regulations and knowledge of procedure and diagnosis codes (CPT, ICD10 coding, HCPCS, APC and DRGs)
Solid Computer Skills-Excel and PowerPoint
Preferred Qualifications:
Advanced degree in health care or medical field
Coding certification through AAPC or AHIMA
5 years of experience in the health care industry (Medicare, Medicaid, Commercial) with deep exposure to Payment Integrity
2 years of experience working in a matrix and highly adaptive environment handling tight deadlines
Knowledge of statistical methods used in the evaluation of healthcare claims data
Proficient SQL coding skills and ability to run test queries to ensure viability of concepts under review
Proven solid project management approach with excellent critical thinking and problem-solving skills
Proven exceptional presentation, communication and negotiation skills
Proven self-managed, self-starter with the ability to support multiple concurrent projects and meet tight delivery timelines
Proven highly collaborative and consultative style with ability to establish credibility quickly with all levels of management across multiple functional areas
Proven ability to think outside of the box and breakdown complex problems into individual root causes
Careers with Optum.
Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.
California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only:
The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $85,000 to $167,300. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, youll find a far-reaching choice of benefits and incentives.
*All employees working remotely will be required to adhere to UnitedHealth Groups Telecommuter Policy.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
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-****
Expires:
2023-07-01
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