Senior Consultant, Analytical Development - Remote in Plymouth, MN, USA (2023)

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Optum is a global organization that uses technology to deliver care to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by giving people the care, pharmacy services, data and resources they need to be well. Here you will find a culture of diversity and inclusion, skilled colleagues, comprehensive benefits and opportunities for professional growth. Make an impact in the communities we serve and help us advance health equity on a global scale. Start with uscaring. Connect. grow together.

As Analytical Development Sr. As a consultant, you will be responsible for supporting the identification, development and presentation of new medical cost-saving opportunities on behalf of our clients. This position supports the evaluation of new opportunities based on data insights leveraging tools, guidelines and industry trends, as well as gathering input from Optum's broad network of experts. This highly skilled industry professional will work with internal and external business communities to identify growth opportunities within our core Payment Integrity businesses and will be responsible for driving savings through implementation.

You'll enjoy the flexibility to work remotely* from anywhere in the US while tackling tough challenges.

Main tasks:

• Identify savings initiatives that deliver specific and measurable results and provide timely and meaningful customer updates
• Participate in analytical, experimental, investigative and other fact-finding work to support concept development
• Build strong relationships with internal and external stakeholders to define, align and execute payment integrity initiatives in support of assigned customers
• Influence senior management to adopt new ideas, approaches and/or products
• Recommend changes to current product development practices based on market research and emerging trends
• Use data mining tools (eg SQL, Access, Excel) to analyze data to support your hypothesis
• Research guidelines, coding guidelines and regulations that support the hypothesis to be developed
• Develop business requirements documentation to be clear, concise and comprehensive
• Communicate the concept clearly to business partners/customers and be able to respond appropriately to questions related to the logic used in hypothesis testing, documentation and analysis
• Perform quality checks on overpayment results and monitor analytical performance
• Provide mentoring and guidance to analytical development consultants
• Industry thought leaders and practice SMEs

You will be rewarded and recognized for your performance in an environment that challenges you and provides you with clear guidance on what is required to succeed in your role and provides opportunities for development into other roles that you may be interested in.

Required qualifications:

• BA/BS or equivalent experience
• 3+ years of healthcare experience (invoicing, coding, claims review)
• 2+ years of experience analyzing large data sets
• 1+ years of SQL experience (PLSQL, Teradata, MySQL)
• 1+ years experience with claims processing or decision making systems (such as UNET, COSMOS, Facets, Diamond, etc. or vendor billing/coding skills for professional and facility claims)
• Knowledge of healthcare payment methods, policies and coding is required
• Maintains working knowledge of coding standards, billing rules and regulations, and knowledge of procedure and diagnostic codes (CPT, ICD10 coding, HCPCS, APC and DRGs).
• Solid computer skills - Excel and PowerPoint

Preferred Qualifications:

• Advanced degree in healthcare or medical field
• Coding certification by AAPC or AHIMA
• 5+ years of healthcare industry experience (Medicare, Medicaid, Commercial) with extensive experience in payment integrity
• 2+ years of experience in a matrix and highly adaptive environment handling tight deadlines
• Knowledge of statistical methods for assessing health data
• Proficient SQL programming skills and ability to run test queries to ensure the viability of the concepts being tested
• Proven solid project management approach with excellent critical thinking and problem solving skills
• Proven exceptional presentation, communication and negotiation skills
• Proven self-managing and self-launching company with the ability to support multiple simultaneous projects and meet tight delivery deadlines
• Proven, highly collaborative and consultative style with the ability to quickly build credibility at all management levels and across multiple functional areas
• Proven ability to think outside the box and break down complex problems into single causes

Career at Optum.Our goal is to make healthcare easier and more efficient for everyone. When our hands are at work in all aspects of health, you can play a role in creating a healthier world, one realization, one connection and one person at a time. We bring together some of the brightest minds and ideas to push healthcare to its full potential and advance healthcare equity and accessibility. Work with diverse, engaged and high-performing teams to help solve critical challenges.

Only residents of California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington:The salary range for residents of California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington is $85,000 to $167,300. Salary 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, stock purchases, and a $401,000 contribution (all benefits are subject to eligibility requirements ). No matter where or when you start a career with UnitedHealth Group, you will find a wide range of benefits and incentives.

*All employees who work remotely must comply with UnitedHealth Group's telecommuting policy.

Our mission at UnitedHealth Group is to help people live healthier lives and make the health care system work better for everyone. We believe that everyone – regardless of 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 that disproportionately affect people of color, historically marginalized groups, and those with lower incomes. We strive to reduce our impact on the environment and to enable and deliver equitable care that eliminates health disparities and improves health outcomes—a corporate priority reflected in our mission.



Diversity Creates a Healthier Atmosphere: UnitedHealth Group is an equal employment opportunity/affirmation employer and considers all qualified applicants for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, or sexual orientation, gender identity, or expression, marital status, genetic information or other characteristics protected by law.

UnitedHealth Group is a drug-free workplace. Applicants must pass a drug test before beginning employment.

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