No industry is moving faster than health care. And no organization is better positioned to lead health care forward than UnitedHealth Group. We need attention to every detail with an eye for the points no one has considered. The rewards for performance are significant. As the Senior Health Care Economics Consultant, you will perform critical research and investigation of key business problems. Using phenomenal analytical skills, you will develop and improve quantitative data analytics and set performance targets for the enterprise. As a subject matter expert, you will interpret and analyze clinical data from various sources and recommend best approaches for its consolidation. You will lead a team in identifying potential areas for medical cost improvements and alternative pricing strategies. There are new challenges and bigger rewards around every turn. Now is the time, and this the place where you'll find a career in which you can make a big difference in our company, our industry, even our world. Join us. And start doing your life's best work.(sm) Primary Responsibilities: Develop and improve quantitative data analytics and set performance targets Research client payment policy and write detail Business Requirement documents for analytic development Work closely with development to create analytic results Work closely with ETL team mapping and validating client data Perform detailed quality assurance on analytic results Lead projects to completion by contributing to database creation, statistical modeling and financial reports Interpret and analyze clinical data from various sources and recommend best approaches Provide claims, premium, capitation and membership data in support of Underwriting, Actuarial and utilization analyses Create and update automated processes Analyze reporting tools to investigate sources of variations Produce and review reports
Required Qualifications: Bachelor's degree or equivalent work experience 3+ years of work experience in a corporate setting 3+ years of experience in health care analytics and working with large data sets Intermediate level of proficiency working with MS Excel including formulas, calculations, charts, graphs, etc. Maintains working knowledge of Medicare rules and regulations and knowledge of procedure and diagnosis codes (CPT, ICD-9 / 10 coding, HCPCS and DRGs)Preferred Qualifications: Medical Claim Coding experience / certification (i.e. CPC, CSS, etc.) Experience with analytics for payment integrity Basic level of proficiency with SQL Basic level of proficiency with Access Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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. Job Keywords: commercial clients, analytics, Highmark, Wellcare, data analysis, claims, Excel, CPT, ICD, Telecommute, Remote, work from home
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.