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Senior Healthcare Economics Consultant, Payment Integrity - Eden Prairie, MN or Telecommute more...
Location:Hopkins (Eden Prairie), MN
First posted:May 25, 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 Ideation Leader, you will be responsible for the function that identifies, develops, and obtains approval of new medical cost savings opportunities with our Payment Integrity clients. You will oversee a team driving this work and lead dialogue related to cost reduction opportunities and risks. Additionally you will be responsible for coordinating the analytic solutions that deliver client savings with Optum business partners and interact with senior Optum and client leaders with a focus on performance to achieve business objectives.

Primary Responsibilities:

Oversee the ideation function that identifies medical cost savings opportunities and manage that portfolio of work to maximize client value delivery

Participate in analytical, investigative, and other fact-finding work in support of new concept development

Establish strong client and matrix partner relationships to define, align, and deliver payment integrity solutions in support of assigned clients

Provide executive level program updates and manage Optum team escalations

Influence client leadership to adopt new ideas, approaches, and/or products

Recommend changes to current product development procedures based on market research and new trends

Operate as an industry thought leader and Payment Integrity SME

Required Qualifications:

BA / BS degree or equivalent experience

2-5 years experience in Payment Integrity or with billing, coding, and auditing claims

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

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

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: 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 Ideation Leader, billing, coding, auditing, claims, CMS, AAPC, AHIMA, SQL, Eden Prairie, MN, Minnesota

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