Payment Integrity Ideation Analyst – Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
The Payment Integrity Ideation Analyst within the Facility Pod is responsible for the research, sizing, analysis, and delivery of payment integrity content and innovation programs in the Concept Research and Development space. This role works with UHC business, Business Analysts, UHC network, UHC policy, solutioning partners across Optum and UHC. The Ideation Analyst Lead works with the CRD Ideator and mentors other CRD Analysts to socialize ideas, create documentation, slide decks and works through the PICOG Governance process with UHC. The Ideation Lead Analyst works with multiple teams on new concept initiatives, and engages solutioning support when needed, and addresses issues by working across the UHG matrix in the relevant team. Analysts develop status materials to communicate project progress, monitors concept analysis and approvals and address issues.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:

Establish solid matrixed relationships with internal and external stakeholders to address needs related to concept development and implementation for Payment Integrity Growth

Analyze, and deliver new growth concepts, updates, and implementation tasks

Triage issues to solution teams and manage them to completion

Communicate analysis and research findings to delivery teams, business teams and data scientists

Monitors metrics and performance information for business review processes

Participates in approval, governance, and other presentations as needed

Leverages analytic tools and strategies to produce analysis to improve yield and quality of solutions

Diagnoses opportunities for, and promotes process reengineering, automation, quality, and efficiency endeavors

Collaborates with the data science and delivery teams to meet operations, product, and client needs

Mentors/coaches other CRD Analysts on all deliverables

Leads Change Management across Concept Research and Development

The successful candidate will be a payment integrity or ideation and growth professional with experience healthcare coding, claims, payment integrity operations, analyzing data, working in cross functional teams, building relationships, explaining and building complex processes, and communicating information related to Payment Integrity Ideation & Growth. Those best suited for this position have solid task execution, planning, execution, payment integrity business, analytic, mentoring/coaching and relationship skills. The role requires the ability to discuss and manage deliverables at a rapid pace in a highly matrixed environment. This position requires a self-starter who is passionate about delivering maximum value from Optum’s Payment Integrity Ideation and Growth through the collaboration with matrix partners and clients.
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:

2+ years with claims data analysis on UNET platform experience

2+ years with Payment Integrity and/or Claims Auditing experience

2+ years of experience with claims data validation and claims pricing methodologies

2+ years of experience of Healthcare Facility (i.e. Hospital, Surgery Center, etc.) auditing, billing, and/or coding claims within a Payment Integrity domain

2+ years of experience performing research and analysis of claims data and applying results to identify trends/patterns

Experience with health care and analytics with ability to translate complex analytic results

Preferred Qualifications:

Solid computer skills: Excel (Pivot Tables, Advanced Formulas, macros, etc..), Visio, PowerPoint, Tableau

Demonstrated ability to be organized, disciplined and capable of ensuring a large volume of work is moving to schedule

Proven self-managed, self-starter, able to work in rapidly changing environment

Proven excellent verbal and written communication skills

Proven solid problem-solving skills, initiative, and creativity in anticipating and solving issues and implementing next steps

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New York, New Jersey, Rhode Island, Washington or Washington, D.C. Residents Only: The salary range for this role is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.
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.

UnitedHealth Group