Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)
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 telecommute* from anywhere within the U.S. as you take on some tough challenges.
- 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.
- 5+ years of experience auditing, billing, and/or coding claims
- 5+ years of experience in the health care industry (Medicare, Medicaid, Commercial) with deep exposure to Payment 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
- 3+ years of experience with interpreting data sets
- 3+ years of experience presenting proposals to stakeholders and internal customers
- 3+ years of Project Management experience
- Maintains working knowledge of CMS rules and regulations and billing codes and related services
- Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance
- Undergraduate Degree
- Advanced degree in health care or medical field
- Previous experience working with Behavioral Health Claims Data
- 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
- Coding certification through AAPC or AHIMA
- Proficiency with SQL, SAS and/or other statistical programs
- Solid computer skills: Excel, Visio, PowerPoint, Tableau
- Solid project management approach with excellent critical thinking and problem-solving skills
- Self-managed, self-starter with the ability to support multiple concurrent projects and meet tight delivery timelines
- Exceptional presentation, communication and negotiation skills
To protect the health and safety of our workforce, patients, and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state, and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.
Careers with Optum. 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)
Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $94,500 to $171,700. The salary range for Connecticut / Nevada residents is $94,500 to $171,700. 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, you’ll find a far-reaching choice of benefits and incentives.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
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.
Job Keywords: Associate Healthcare Econ Director, PI Behavioral Health, Heathcare, Work At Home, WAH, Work From Home, WFH