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Healthcare Economic Consultant - Franklin, TN or Wauwatosa, WI

UnitedHealth Group

Franklin, TN
Job Code:
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Job Details

Healthcare Economic Consultant - Franklin, TN or Wauwatosa, WI(Job Number:723822)

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)                                                  


Primary Responsibilities:

  • Research potential overpayment scenarios through the use of client policies and provider contracts, seeking to identify overpaid claims used to build recurring algorithms

  • Identify and refine criteria to successfully build and enhance new and existing algorithm logic ensuring correct claim payment

  • Research and quickly Identify patterns of claim payment abnormalities through big data analysis

  • Develop metrics to forecast new algorithm profitability

  • Write business requirement documents for new algorithms and update existing documents as the algorithm logic is developed or changes over time

  • Maintenance existing production algorithms to maximize performance while working directly with the programmers to test and implement changes

  • Facilitate new algorithm kick off calls and training with our matrix partners

  • Monthly analysis of algorithm performance; forecasted vs. actuals

  • Provide management weekly reports outlining work completed and issues encountered

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

  • Breakdown complex problems into individual root causes



Job Healthcare Econ & Analytics
Primary Location US-TN-Franklin
Other Location US-WI-Wauwatosa
Organization Optum Ops-Shared Svcs Analytcs
Schedule Full-time
Number of Openings 1
Apply on the Company Site

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.

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