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Senior Healthcare Economics Consultant, Payment Integrity - Eden Prairie or Telecommute more...
Location:Hopkins (Eden Prairie), MN
First posted:May 26, 2017

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, 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 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 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

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:

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 a matrix 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

Self-managed, self-starter with the ability to support multiple concurrent projects and meet tight delivery timelines
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: 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: Senior Healthcare Economics Consultant, Payment Integrity, billing, coding,auditing, claims, telecommute, telecommuter, remote, work from home

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