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Careers at UnitedHealth Group


We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM


Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com


Job Category:



United States

Postal Code:


Approximate Salary:

Not Specified

Position Type:

Full Time

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Recovery Resolution Consultant / Ideation Analyst - Franklin, TN

UHG - Franklin, Tennessee

Posted: 10/12/2018


Energize your career with one of Healthcare’s fastest growing companies.  


You dream of a great career with a great company – where you can make an impact and help people.  We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives.  We live for the opportunity to make a difference and right now, we are living it up.


This opportunity is with one of our most exciting business areas: Optum - a growing part of our family of companies that make UnitedHealth Group a Fortune 6 leader.


Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.


Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.


Primary Responsibilities:

  • Identify patterns of claim payment abnormalities that will lead to new rule development through data and claim analysis

  • Identify patterns of claim payment abnormalities that will lead to one off payment error identification

  • Research new leads for viability

  • Populate client’s test file templates and gather all supporting documentation for trend approval

  • Assist on client calls with the presentation of new rules for client approval

  • Facilitate new rule kick off calls with Operations, Centers of Excellence, and the recovery team

  • Weekly management reports outlining work completed and issues encountered

  • Competencies and Best Practices for High Performers

  • Breakdown complex problems into individual root causes

  • Perform vendor analysis and present findings to management teams

  • Quickly identify payment errors regardless of claim system by means of data analysis

  • Identify and refine criteria to successfully increase efficiency of rule logic

  • Serve as a team lead in the absence of the Operations Manager

  • Subject matter expert on client processes and policies

  • Assist management and sales with product assessments for new business

  • Train analysts within and outside of Operations

  • Lead special projects with little to no manager supervision or assistance

  • Perform validation steps for new client implementations

Required Qualifications:

  • Bachelor's Degree (or higher) or High School Diploma / GED and 3+ years of health care experience working with claims data and / or medical codes

  • 2+ years of health care experience working with claims data and / or medical codes

  • Experience analyzing large data sets to determine trends / patterns

  • Experience reading and interpreting provider contracts, fee schedules, and claim payment policies

Preferred Qualifications:

  • Intermediate level of proficiency working with Microsoft Excel including formulas, calculations, charts, graphs, etc.

  • Experience with Medicaid payment policies

  • Coding Certification: CPC, CPC - P, COC, CCS, or CCA, CCS-P

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.


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.


Keywords: UnitedHealth Group, Optum, claims, claims data, coding, healthcare, medical codes, claim payment, medicare, medicaid

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