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.
As an SIU Consultant on the Optum Payment Integrity Commercial FWA/SIU team you will provide a broad range of services focusing on detecting, quantifying and reporting incidents of potential FWA in support of commercial health plan payment integrity and cost containment initiatives.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Responsible for delivering on the strategic direction for Optum Payment Integrity’s commercial SIU business
Create, Implement and design new data mining analytics utilizing ECG Cockpit
Responsible for simultaneously supporting 4-6 SIU Consulting team members on data requests utilizing Smart Base and other data repositories
Direct experience developing, maintaining and optimizing large data warehouse repositories for complex data analysis to support internal and external payment integrity clients
Ability to create and execute a project plan and delivery of new client implementations
Maintain vendor relationships through a regular cadence of meeting to ensure data integrity
Partner with matrixed organizations (e.g. analytics, technology, finance, and human capital, sales) to ensure planned results are delivered
Develop an excellent working relationship with clients, both at the executive and daily operational levels. Drive results by exceeding client expectations
Responsible for attaining critical goals and upholding a high standard of operational performance
Work to drive for continuous improvement within the business; past experience driving process improvement initiatives; small scale and large scale is highly desired
Support internal and external communication strategies to proactively share with clients the value being driven for them and simultaneously engage the employee base within the business
Identify and execute on new opportunities for increases in contracted/delivered services as well as efficiencies and performance
Apply analytical / quantitative approach to problem solving
Possess the ability to obtain and use data, and comfortable with statistical concepts
Utilize communication skills to influence client actions to improve their tactical payment integrity strategy and performance
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:
5+ years of experience in MS SQL Servers, Oracle SQL, UHC claim adjudication platforms and applications, ProClaim, NASCO and MS application suite at a expert level
1+ years of relationship management, consulting experience or client facing role
Demonstrated experience in prioritizing and balancing multiple demands and competing deadlines
Preferred Qualifications:
Proven solid verbal and written communication skills
Proven ability to produce superior results in a results-oriented environment
Proven ability to operate in a highly dynamic environment
Proven solid financial analysis and risk management skills
Ability to understand and influence the necessary and appropriate actions to ensure maximization of financial results and objectives of consulting engagements; a bias for action is critical
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
The salary range for this role is $89,800 to $176,700 annually based on full-time employment. 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
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