Payment Integrity Ideation Consultant - Eden Prairie, MN (Preferred) or Telecommute
February 10, 2018
Eden Prairie, Minnesota
As an 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. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities: Support existing and develop new medical record review and administrative hold concepts / edits that drive specific and measurable resultsProviding timely and meaningful client updatesParticipate in analytical, experimental, investigative and other fact-finding work in support of concept developmentEstablish strong relationships with internal and external stakeholders to define, align, and deliver payment integrity initiatives in support of assigned clientsInfluence senior leadership to adopt new ideas, approaches, and/or productsRecommend changes to current product development procedures based on market research and new trendsIndustry thought leader and practice SME
Required Qualifications:BA / BS degree or equivalent experience3 or more years of experience in the health care industry (Medicare, Medicaid, Commercial) with deep exposure to Payment Integrity3 or more years of experience billing, coding, and auditing claimsStrong computer skills: Access, Excel, Visio, PowerPoint & Basic level proficiency with SQLWorking knowledge of CMS rules and regulations Knowledge of correct coding guidelines (CPT, HCPCS, DRG and ICD 9/10)Knowledge of reimbursement methodologies (FFS / professional, APC, DRG, etc.)Preferred Qualifications: Advanced degree in health care or medical fieldFraud Waste and Abuse experience 2 or more years of experience working in a matrix and highly adaptive environment handling tight deadlinesCoding certification through AAPC or AHIMA Experience reviewing and interpreting medical claims healthcare data from a medical coding and reimbursement perspectiveKnowledge of statistical methods used in the evaluation of healthcare claims dataSoft Skills: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 timelinesStrong project management approach with excellent critical thinking and problem solving skillsExceptional presentation, communication and negotiation skills 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) *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. 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: Payment Integrity Ideation Consultant, Eden Prairie, MN, Minnesota, Telecommute, Remote, Work from Home
Internal Number: 747861
About UnitedHealth Group
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.