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Ideation Analyst - Franklin, TN

UnitedHealth Group

Franklin, TN
Job Code:
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Job Details

740649 Ideation Analyst Franklin TN

Ideation Analyst - Franklin, TN (740649)

Position Description

You dream of a great career with a great company - where you can make an impact and help people.  We dream of giving you the opportunity to do just this.  And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives.  We live for the opportunity to make a difference and right now, we are living it up.
This opportunity is with one of our most exciting business areas: Optum - a growing part of our family of companies that make UnitedHealth Group a Fortune 6 leader.
Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation and Performance.
Primary Responsibilities:
  • Identify patterns of claim payment abnormalities that will lead to new rule development through data and claim analysis
  • Identify patterns of claim payment abnormalities that will lead to new trends in payment error identifications
  • Research new leads for viability
  • Populate client’s test file templates and gather all supporting documentation for trend approval
  • Assist on client calls with the presentation of new rules for client approval
  • Facilitate new rule kick off calls with Operations, Centers of Excellence, and the recovery team
  • Weekly management reports outlining work completed and issues encountered
  • Competencies and Best Practices for High Performers
  • Breakdown complex problems into individual root causes
  • Perform vendor analysis and present findings to management teams
  • Quickly identify payment errors regardless of claim system by means of data analysis
  • Identify and refine criteria to successfully increase efficiency of rule logic
  • Lead special projects with little to no manager supervision or assistance
Required Qualifications:
  • Bachelor's Degree (or higher) or High School Diploma / GED and 3+ years of health care experience working with claims data and / or medical codes
  • 2+ years of health care experience working with claims data and / or medical codes
  • Experience analyzing large data sets to determine trends / patterns
  • Experience reading and interpreting provider contracts, fee schedules, and claim payment policies

Preferred Qualifications:

  • Intermediate level of proficiency working with Microsoft Excel including formulas, calculations, charts, graphs, etc.
  • Experience with Medicaid payment policies
  • Coding Certification: CPC, CPC-P, COC, CCS, or CCA, CCS-P

Physical Requirements and Work Environment:

  • Frequent speaking, listening using a headset, sitting, use of hands / fingers across keyboard or mouse, handling other objects, long periods working at a computer
  • Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity
UnitedHealth Group is a team of more than 260,000 people who are building career success through commitment, compassion and a desire to make a difference. Join us. Learn more about how you can start doing your life's best work.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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.
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.
Keywords: Optum, Ideation Analyst, Franklin, TN, CPC, CPC-P, COC, CCS, CCA, CCS-P, medical codes

Job Details

  • Contest Number740649
  • Job TitleIdeation Analyst - Franklin, TN
  • Job FamilyClaims
  • Business SegmentOptum Operations

Job Location Information

  • Franklin, TN
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionNo
  • Overtime StatusNon-exempt

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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