Vice President: Payment Integrity Analytics - Optum - Eden Prairie, MN

If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work

 

This position is part of the senior leadership team overseeing Optum's Payment Integrity Analytics and is a direct report of the leader of the business. 

 

This position will bring together analytic thought leadership and a deep knowledge of the health care industry to the development of game changing analytics for the detection, prevention and recovery of aberrant claims.  Responsibilities include leading a team of analytic professionals in the development of innovative and leading edge analytics that significantly reduce health care administrative costs.  This position will also lead our efforts to bring to market competitively superior analytic capabilities.

• Analytic Strategic Planning: Responsible for significant contributions to the development of the strategic direction for our payment integrity analytics business in partnership with Payment Integrity Operations leadership and the Market Leaders (UHC, Commercial and Government) to include vision, mission and 1 and 3 year plans.


• Capability Organizational Structure: Responsible for driving the planning and execution of the shift of the Payment Integrity Analytic organization model from multiple siloed analytic units (FWA, DM, COB, Rules, Predictive Models) to a capability-driven business.

·         Analytic Innovation: Catalyst for analytic innovation and thought leadership resulting in a robust analytic pipeline and inventory to meet and exceed financial commitments to our clients.

• Commercialization of Analytics:  Reinvent existing analytics and create new analytics that appeal to external commercial clients and governments  


• Analytic Industry Thought Leader: Participate in analytic industry forums to garner greater insight into market influences and client needs


• Collaborate and Influence: Deepen partnership with matrixed organizations (e.g. Operations, technology, finance, and human capital, sales) to ensure planned analytics are deployed within budget, on time and meet performance expectations.


• Establish business cadence (weekly, monthly, quarterly analytic reviews) to ensure Analytic results are met and exceeded and to drive higher levels of performance. 


• Analytic Metrics: Own development, distribution and communication of Analytic metrics requested by our clients and partner.   Ensure Analytic metrics are used to continuously improve analytics.


• Training and Quality: Ensure relevant and continuous training and quality programs are established to educate internal staff and third party vendors to produce desired outcomes.


• Leadership Development: Provide coaching and leadership development to both on and offshore teams.


• Client Relationships: Develop excellent working relationship with clients, both at the executive and daily execution levels.  Drive plans to exceed client expectations and delight our clients.


• Analytic Communications Strategy: Develop an internal and external communication strategy to proactively share with clients the value being driven for them and simultaneously engage the employee base within the business.


• Change Management: Serve as a catalyst for change – challenge the status quo and bring high level of intellectual curiosity to bear to improve the analytic businesses.

 

• Passion for health care analytics and the tenacity to change legacy processes


• 10 + years experience in the development of predictive models - with healthcare claims data strongly desired


• 5+ years experience bringing analytic solutions to the market – health care experience strongly desired


• Advanced degree (Master's or PhD in mathematics, epidemiology, (bio)statistics, machine learning or related field


• Knowledge of advanced statistical methods used in the evaluation of healthcare claims data (unsupervised models, parametric, non-parametric, neural networks, clustering, social network analysis etc.)


• Ability to grasp analytical concepts and clearly understand how analytical solutions can help customers reduce their healthcare costs


• Demonstrated experience in providing leadership to colleagues and senior management in innovative statistical techniques


• Exceptional ability to drive results through strong collaborating and influencing skills across all business segments and geographies


• High energy, detailed oriented with the ability to manage and prioritize multiple projects to ensure their quality and on-time delivery 


• Strong problem solving skills, demonstrates initiative and creativity by originating new ideas, anticipating and implementing next steps


• Self-managed, self-starter, able to work in rapidly changing environment


• Excellent communication and negotiation skills.


• Strong interpersonal skills, ability to work with all levels of management across all functional areas, as well as, business partners in other UHG entities


• Excellent verbal and written communication skills.

 

Competencies

• Analytic Thought Leadership


• Attracting and developing senior analytic talent 


• Drive for Results


• Interpersonal Savvy


• Customer Focus

OptumInsight is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

If you get excited about the life transforming potential of bringing health care information to the right place, at the right time, to support crucial decisions, welcome to OptumInsight.

We're one of the largest and fastest growing health information companies and the only organization in our industry with the information, technology and consulting expertise to solve the most significant challenges in health and human services.

As a vital member of the UnitedHealth Group family, we serve customers in every segment of the health care field. This includes government agencies, pharmaceutical companies, hospitals and health delivery networks, insurance providers and, of course, the diverse business divisions of UnitedHealth Group.

Bring your talent to an industry leader with the information, technology, and consulting expertise to help transform health and human services. No matter what your role, you'll be empowered to ask more questions, develop better solutions and help make the health care system greater than ever.

 

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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.SM

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.




UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.