Health Care Economics Consultant - Eden Prairie, MN(Job Number:698645)
Some people take things as they come. Others relentlessly push themselves to go farther. Combine health care and technology, which are two of the fastest-growing fields on the planet, with UnitedHealth Group's culture of performance, collaboration and opportunity and this is what you get: industry-leading health care services at a company that's improving the lives of millions.
As the Health Care Economics Consultant you will design and develop reports and analyze data to measure clinical outcomes, network performance and methodology levers. You will investigate key business problems through quantitative analyses of utilization and health care costs data. As the Consultant, you will interpret and analyze clinical data from various sources and recommend best approaches for its consolidation. Your analyses will be used to create viable, real-world solutions in a complex health care landscape. The work is as challenging as it is rewarding. You'll open doors to new opportunities. This is where bold people with big ideas are writing the next chapter in health care. Join us. There's never been a better time to do your life's best work.(sm)
This requisition is to fill a position in the Optum Performance Management team in support of our Fraud Analytics area. The Performance Management team was created to develop, standardize and implement the methodologies required to evaluate and improve the performance of Payment Integrity analytics. The team’s focus is the development of analytic metrics, the analysis of results and the identification of opportunities for false positive reduction in order to increase client savings and improve operational efficiency.
Primary focus area is the detection and prevention of fraud, waste and abuse for professional claims, through the rules-based analytics. These rules maximize claim payment accuracy, overpayment recovery, and education of our provider community. To ensure optimal performance and accuracy, existing rules are refined based on performance feedback and to adhere to regulatory compliance for updated code sets
Gather and prepare analysis based on information from internal and external sources to evaluate and demonstrate program effectiveness and efficiency
Develop scalable reporting processes and querying data sources to conduct ad hoc analyses
Research complex functional issues using a variety of resources
Develop and prepare highly complex reports and provide and / or interpret information and data across divisions and departments
Assume responsibility for data integrity among various internal groups and/or between internal and external sources
Provide source system analysis
Job Healthcare Econ & Analytics
Primary Location US-MN-Eden Prairie
Organization Optum Ops-Shared Svcs Analytcs
Number of Openings 1