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 deliveryParticipate 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 clientsProvide executive level program updates and manage Optum team escalationsInfluence client leadership to adopt new ideas, approaches, and/or productsRecommend changes to current product development procedures based on market research and new trendsOperate as an industry thought leader and Payment Integrity SME
Required Qualifications:BA / BS degree or equivalent experience2-5 years' experience in Payment Integrity or with billing, coding, and auditing claimsStrong 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 field5+ years' experience in the health care industry (Medicare, Medicaid, Commercial) with deep exposure to Payment Integrity2+ years' experience working in a matrix and highly adaptive environment handling tight deadlinesCoding certification through AAPC or AHIMA Basic level proficiency with SQLKnowledge of statistical methods used in the evaluation of healthcare claims dataSelf-managed, self-starter with the ability to support multiple concurrent projects and meet tight delivery timelinesStrong project management approach with excellent critical thinking and problem solving skillsExceptional presentation, communication and negotiation skillsHighly collaborative and consultative style with ability to establish credibility quickly with all levels of management across multiple functional areasCareers 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
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.