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 CPC - certified Senior Research Analyst Consultant, you will act as a Delivery Manager working directly with a State Government agency, and you will be responsible for the identification, development, and presentation of new medical cost savings opportunities on behalf of this client. 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: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 clients to define, align, and deliver payment integrity initiatives Influence the client 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
- BA / BS degree or equivalent work experience
- 3+ years of experience billing, coding, and auditing claims
- 3+ years of Medicaid billing, claims or contract work experience
- CPC Certification
- Strong computer skills: Access, Excel, PowerPoint
- Active CPC certification
- Maintains working knowledge of CMS rules and regulations and knowledge of procedure and diagnosis codes (CPT, ICD - 9 / 10 coding, HCPCS and DRGs)
- Advanced degree in health care or medical field
- Nursing degree
- 5+ years of Medicaid billing, claims or contract work experience
- 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
- Basic level proficiency with SQL, MS Visio
- 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
- Strong project management approach with excellent critical thinking and problem solving skills
- Exceptional presentation, communication and negotiation skills
UnitedHealth Group is a Fortune 6 company with all the resources you'd expect from the largest networks of physicians, hospitals, health facilities and caregivers in the United States and more than 125 other countries. Join us and be inspired to do your life's best work.(sm)
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.
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