Sr Consultant Analytic Development Commercial R&D - Remote

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? 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.

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.

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

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/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) 
• An 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:  Access, Excel, Visio, PowerPoint 
• Highly collaborative and consultative style with ability to establish credibility quickly with all levels of management across multiple functional areas
• Proven solid project management approach with excellent critical thinking and problem-solving skills
• Proven exceptional presentation, communication and negotiation skills
• Proven ability to think outside of the box and breakdown complex problems into individual root causes
• Proven to be self-managed, self-starter with the ability to support multiple concurrent projects and meet tight delivery timelines

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
• 3+ years of experience conducting analysis on large data sets 
• 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
• Expert SQL coding skills and ability to run test queries to ensure viability of concepts under review

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

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.