1+ months

Payment Integrity Ideation Leader - Facility - Telecommute - 900201

St Paul, MN 55102 Work Remotely
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  • Job Code
    900201

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

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Positions in this function research and investigate key business problems through quantitative analyses of utilization and healthcare costs data. Provides management with statistical findings and conclusions. Identifies potential areas for medical cost improvements. Provides data in support of actuarial, financial and utilization analyses.

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  • Provides leadership to and is accountable for the performance and direction through multiple layers of management and senior level professional staff.
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  • Work most often impacts a large business unit, or multiple markets/sites.
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  • For this position, have a background in Fraud, Waste & Error
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Youll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

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Primary Responsibilities:

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  • Identify, create, and develop a portfolio of cost savings initiatives that drive specific and measurable results for assigned clients while providing timely and meaningful client updates
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  • Lead a team of up to 8 team members comprising of SMEs and Data Analysts
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  • Be accountable for the savings portfolio of the team, managing inventory and driving incremental savings
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  • Perform and participate in iterative analytical, experimental, investigative and other fact-finding work in support of concept development
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  • Establish strong matrixed relationships with internal stakeholders to define, align, and deliver payment integrity initiatives in support of assigned clients
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  • Influence senior leadership to adopt new ideas, approaches, and/or products
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  • Recommend changes to current product development procedures based on market research and new trends
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  • Industry thought leader and subject matter expert for Fraud, Waste and Error (and related trends, pricing, and cost management initiatives
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  • Lead concepts/projects from conceptualization to completion
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Youll 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.
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Required Qualifications:

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  • Bachelor's degree or equivalent work experience
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  • 5 or more years of supervisory experience
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  • 5+ years experience working in a matrix and highly adaptive environment handling tight deadlines
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  • 3+ maintaining working knowledge trends and opportunities for medical cost savings
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  • 3+ years experience in claims adjudication or revenue cycle management with specialization in processing Facility claims
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  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders
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"Preferred Qualifications:

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  • Advanced degree in health care or medical field
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  • Coding certification through AAPC or AHIMA
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  • 5+ years experience in the health care industry (Medicare, Medicaid, Commercial) with deep exposure to Payment Integrity
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  • 3+ years of experience auditing, billing, and/or coding claims
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  • Strong communication skills including explaining complex concepts effectively to technical and nontechnical audience, negotiation and persuasion, conflict resolution, and presenting to executive levels management
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  • Highly collaborative and consultative style with ability to establish credibility quickly with all levels of management across multiple functional areas
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  • Self-managed, self-starter with the ability to support multiple concurrent projects and meet tight delivery timelines
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  • Strong project management approach with excellent critical thinking and problem-solving skills
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  • Exceptional presentation, communication and negotiation skills
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  • Strong computer skills: Excel, Visio, PowerPoint, Tableau
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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)

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Colorado Residents Only: The salary range for Colorado residents is $110,200 to $211,700. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

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*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy

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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.
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"UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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Job Keywords: Medical Claims, Medical Coding, Claims Adjudication, Healthcare, Facility Claims

Posted: 2021-01-30 Expires: 2021-03-12

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

Sponsored by:
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Payment Integrity Ideation Leader - Facility - Telecommute - 900201

UnitedHealth Group
St Paul, MN 55102

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