Payment Integrity Ideation Associate Director APC Coder – Remote

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.

 

Positions in this function research and investigate key business problems through quantitative analyses of utilization and healthcare costs data. Provides management with statistical findings and conclusions. Identifies potential areas for medical cost improvements and alternative pricing strategies. Provides data in support of actuarial, financial and utilization analyses.

 

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

 

Primary Responsibilities:

• Identify, create, and develop a portfolio of cost savings initiatives that drive specific and measurable results for assigned clients while providing timely and meaningful client updates
• Perform and participate in iterative analytical, experimental, investigative, and other fact-finding work in support of concept development
• Establish strong matrixed relationships with internal 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
• Industry thought leader and subject matter expert for medical claims, related trends, pricing, and cost management initiatives
• Lead concepts/projects from conceptualization to completion

 

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:        

• Coding certification through AAPC or AHIMA with 4+ years of experience in APC coding and Outpatient Reimbursement
• 4+years of experience auditing, billing, and/or coding claims within a Payment Integrity domain
• 4+ years of experience in the health care industry (Medicare, Medicaid, Commercial) with deep exposure to Payment Integrity or Revenue Integrity
• 3+ years of work experience in highly collaborative and consultative roles, with ability to establish credibility quickly with all levels of management across multiple functional areas
• 2+ years of experience performing research and analysis of claims data and applying results to identify trends/patterns.
• 2+ years of experience presenting proposals to stakeholders and internal customers
• Maintains working knowledge of CMS rules and regulations and billing codes and related services 

 

Preferred Qualifications:        

• Advanced degree in health care or medical field
• 3+ years of experience in claims adjudication or revenue cycle management 
• 2+ years of experience working in a matrixed and highly adaptive environment handling tight deadlines
• Solid computer skills: Excel (Pivot Tables, Advanced Formulas, macros, etc..), Visio, PowerPoint, Tableau 

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

 

California, Colorado, Connecticut, Hawaii, Maryland, Nevada, New Jersey, New York, Rhode Island, Washington, or Washington, D.C. Residents Only: The salary range for this role is $104,700 to $190,400 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with al minimum wage laws as applicable. 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, you’ll find a far-reaching choice of benefits and incentives.

 

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

 

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 – free workplace. Candidates are required to pass a drug test before beginning employment.