Policy Research Consultant- Remote

UnitedHealth Group

  • Eden Prairie, MN
  • $70,200-137,800 per year
  • Permanent
  • Full-time
  • 20 days ago
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.As a Policy Research Consultant, you will be responsible for the identification, development, and presentation of new policy-related medical cost savings opportunities on behalf of our clients. This position will assess new opportunities based on data insights leveraging tools, policies, industry trends, and by soliciting input from a broad network of experts across Optum. This highly trained industry expert will work with internal and external business constituents to determine opportunities for growth within our core payment integrity businesses and be responsible for savings delivery through deployment.You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:
  • Research and identify industry guideline support for new medical cost savings initiatives across Medicare, Medicaid, and Commercial lines of business
  • Partner with data team and conduct claims data analysis to determine viability of new reimbursement policy opportunities
  • Collaborate with internal and external cross-functional teams to assess risk and gain alignment on new / enhanced policy direction and development
  • Thoroughly and accurately evaluate and package reimbursement policy affordability concepts for clients to ensure acceleration, prioritization, quality, and successful approval and implementation
  • Contribute policy thought leadership and research on Payment Integrity strategic initiatives and programs as needed
  • Mitigate issues / risks on policy concepts and escalate with leadership as appropriate
You’ll 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.Required Qualifications:
  • CPC, COC (formerly CPC-H), CIC, or CCA certification
  • 2+ years of experience billing, coding, and/or auditing healthcare claims
  • 2+ years of experience researching Medicaid and other state regulatory guidelines
  • 2+ years of experience researching payment integrity industry guidelines such as CMS, AMA/CPT, etc.
  • Experience presenting, collaborating, and consulting with a variety of stakeholders/clients across functional areas
  • Reimbursement policy development experience
  • Proficiency with MS Outlook (including ability to create and modify meeting invitations)
  • Proficiency with MS Excel (including ability to create spreadsheets, manipulate data, and create pivot tables)
  • Proficiency with MS PowerPoint (ability to populate templates for professional looking client presentations)
Preferred Qualifications:
  • Facility reimbursement experience (includes coding certification in facility)
  • Experience working in a matrix and highly adaptive environment handling tight deadlines
  • Experience in healthcare industry (Medicare, Medicaid, Commercial) with deep exposure to Payment Integrity
  • Experience managing multiple concurrent projects and meeting tight delivery timelines
  • Demonstrated ability to establish credibility quickly with all levels of management
  • Proven solid project management approach with excellent critical thinking and problem-solving skills
  • Proven highly collaborative and consultative style
  • Proven innovative thinker that works well in an ambiguous, growth environment
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for this role is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.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.

UnitedHealth Group