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Healthcare Economic Consultant - Multiple Locations & Telecommute

UnitedHealth Group


Location:
Franklin, TN
Date:
06/23/2017
2017-06-232017-07-22
Job Code:
1747180
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Job Details


Healthcare Economic Consultant - Multiple Locations & Telecommute(Job Number:714008)
Description

The Healthcare Economic Consultant position requires a strong analytical skill set, data analysis and healthcare claims expertise (HCFA/UB) and will involve learning about solutions to detect incorrectly paid claims for all UHC segments (Medicare, Medicaid and Commercial) and claim platforms.  The role is responsible for utilizing all data mining tools (i.e. SAS, Self Service, SQL, Excel, etc.) to complete complex healthcare data queries to identify aberrancies, trends, outliers within claim data.   This role will focus on developing medical concepts in partnership with our Analytic and Operation partners to identify and research potential claims hypotheses; size concepts for potential opportunity and savings; and when confirmed, present the findings for solution approval.  This position requires excellent communication skills in partnership with our client.  An understanding of healthcare payment methodologies and policies as well as coding is recommended.

 

Primary Responsibilities:

  • Researching and developing potential claim overpayment hypotheses

  • Responsible for utilizing data mining tools (i.e. SQL, Access, Excel) in order to analyze data to support of their hypothesis

  • When opportunity is confirmed, the analyst will present the findings for solution approval in a clear and concise manner utilizing data reports and summaries to support their concept

  • An understanding of healthcare payment methodologies and policies as well as coding is necessary

 

 


Job Healthcare Econ & Analytics
Primary Location US-TN-Franklin
Other Location United States, US-MN-Eden Prairie, US-MD-Frederick
Organization OI Payment Integrity
Schedule Full-time
Number of Openings 3
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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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