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. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Advisory Services Senior Consultant
Location
United States
Posted
17 days ago
Salary
Not specified
No structured requirement data.
Job Description
Role Description
This position will be responsible for scoping, analysis, and delivery of analytics-oriented projects.
- Assist in the maintenance and support of the Normalized Pricing product, including product releases, updates, and collaboration with different teams to synchronize the algorithm across various platforms
- Work with clients to coordinate data requests and submissions
- Provide data analytics processing support according to project specifications either individually or through collaboration with other subject matter experts
- Support customers for Normalized Pricing, including product implementation and consultation, coordinating data requests and submissions, making recommendations, performing pricing, analyzing, and explaining results, identifying issues, and providing solutions
- Compile, structure, and present results to customers through spreadsheet reports and additional analytical deliverables, including data visualizations, while explaining key findings, insights, and implications
- Partner with applicable stakeholders to identify and implement operational efficiencies and assess the operational impact of changes within defined solutions
- Engage in the development of new products and solutions to enhance revenue growth opportunities including using AI to streamline processes and work efforts
- May require on occasion working nights and weekends for client support and/or production releases
Qualifications
- 4+ years working with and analyzing medical health care data. Must be familiar with claim structure, data components and relationships that contribute to reimbursement. Pharmacy health care data is a plus
- 4+ years of solid SQL experience, preferably in MS SQL Server environment with knowledge of database maintenance, ETL, and experience with complex scripts
- 2+ years of experience with CMS Prospective Payment System (PPS) frameworks and reimbursement methodologies (e.g., DRG, APC, RBRVS, Per Diem), with solid knowledge of Commercial, Medicare, and/or Medicaid payment models
- 2+ years of proven experience with utilizing Artificial Intelligence to either streamline processes, improve a product/solution or similar
- Proven solid written and verbal communication skills, with keen attention to detail and the ability to effectively present complex information to both technical and executive audiences
Requirements
- Experience with Python, Apache Spark, Cloud Computing and Databricks
- Intermediate to Advanced Proficiency level of skill in Excel. Knowledge of VBA
- Proven excellent data quality assessment skills. Must be able to leverage knowledge of UB and CMS claims to quickly identify problems within a submitted claims dataset
- Proven excellent data analysis skills and a demonstrated ability to assess patterns, trends, and behaviors within large health care claims populations
- Proven ability to work independently while proactively identifying issues and developing effective solutions
Benefits
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution (all benefits are subject to eligibility requirements)
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.
Job Requirements
- 4+ years working with and analyzing medical health care data. Must be familiar with claim structure, data components and relationships that contribute to reimbursement. Pharmacy health care data is a plus
- 4+ years of solid SQL experience, preferably in MS SQL Server environment with knowledge of database maintenance, ETL, and experience with complex scripts
- 2+ years of experience with CMS Prospective Payment System (PPS) frameworks and reimbursement methodologies (e.g., DRG, APC, RBRVS, Per Diem), with solid knowledge of Commercial, Medicare, and/or Medicaid payment models
- 2+ years of proven experience with utilizing Artificial Intelligence to either streamline processes, improve a product/solution or similar
- Proven solid written and verbal communication skills, with keen attention to detail and the ability to effectively present complex information to both technical and executive audiences
- Experience with Python, Apache Spark, Cloud Computing and Databricks
- Intermediate to Advanced Proficiency level of skill in Excel. Knowledge of VBA
- Proven excellent data quality assessment skills. Must be able to leverage knowledge of UB and CMS claims to quickly identify problems within a submitted claims dataset
- Proven excellent data analysis skills and a demonstrated ability to assess patterns, trends, and behaviors within large health care claims populations
- Proven ability to work independently while proactively identifying issues and developing effective solutions
Benefits
- Comprehensive benefits package
- Incentive and recognition programs
- Equity stock purchase
- 401k contribution (all benefits are subject to eligibility requirements)
- 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.
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