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Senior Healthcare Economics Consultant, Payment Integrity Ideation Consultant - Eden Prairie, MN or Telecommute more...
Location:Hopkins (Eden Prairie), MN
Company:OptumInsight
First posted:May 25, 2017
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Do you love the excitement of a fast - paced, high - growth organization? If so, a career at Optum, part of the UnitedHealth Group family of businesses will allow you to serve almost all dimensions of the health system from those who diagnose and treat patients to those who pay for care, deliver health services and those who supply the cures. Optum 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. Join us and learn why there is no better place to do your life's best work.(sm)

As a Senior Healthcare Economics Consultant, Payment Integrity Ideation Consultant, you will be responsible for the identification, development, and presentation of new medical cost savings opportunities on behalf of our clients. This position will assess 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.

Primary Responsibilities:

Identify savings opportunities that drive initiatives resulting in specific and measurable cost reduction for clients
Participate in analytical, investigative and research work in support of concept development
Develop strategic and tactical plans for execution on cost-savings initiatives
Provide timely, concise and meaningful client updates
Establish strong 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
Industry thought leader and practice SME

Required Qualifications:

BA / BS degree or equivalent experience
3 - 5 years experience billing, coding, and auditing claims
Self - managed, self - starter with the ability to support multiple concurrent projects and meet tight delivery timelines
Strong project management approach with excellent critical thinking and problem solving skills
Exceptional presentation, communication and negotiation skills
Strong computer skills: Access, Excel, Visio, PowerPoint
Maintains working knowledge of CMS rules and regulations and knowledge of procedure and diagnosis codes (CPT, ICD - 9 / 10 coding, HCPCS and DRGs)
Preferred Qualifications:

Policy, benefits, and reimbursement knowledge for home health, hospice, and / or nursing home services
Familiarity with Medicaid waiver programs
Advanced degree in health care or medical field
5+ years experience in the health care industry (Medicare, Medicaid, Commercial) with deep exposure to Payment Integrity
2+ years experience working in amatrix and highly adaptive environment handling tight deadlines
Coding certification through AAPC or AHIMA
Basic level proficiency with SQL
Knowledge of statistical methods used in the evaluation of healthcare claims data
Highly collaborative and consultative style with ability to establish credibility quickly with all levels of management across multiple functional areas
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)

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.

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