Healthcare Economic Analyst - Telecommute

Join the Optum Advanced Analytics Lab Performance Monitoring team as a Healthcare Economics Analyst! This requisition is to fill a position in support of Performance Monitoring for our Data Mining Analytics areas. The Performance Monitoring team was created to develop, standardize and implement the methodologies required to evaluate and improve the performance of Payment Integrity analytics. The team's focus is the development of metrics that reflect the health of our analytics and include assessing performance based on hit rate, false positive ratios, and incident bad rates.   Analysis of results and the identification of opportunities leads to increased client savings and improved operational efficiency.

Data Mining Analytics that are being assessed and measured by this position, were developed to find payment errors due to reimbursement policies, contract language, system limitations, coordination of benefits and processor errors or contract loading issues. 

Primary Responsibilities:
-Perform complex claims analysis and audit activities to identify trends
-Determine root cause of payment inaccuracies
-Recommend/implement process and systems improvements
-Research and investigate key business problems through quantitative analysis of data
-Provide management with statistical findings and conclusions.
-Identify areas for performance improvement and alternative strategies
-Gather and prepare analysis based on information from internal and external sources to evaluate and demonstrate program effectiveness and efficiency
-Develop scalable reporting processes and querying data sources to conduct ad hoc analyses
-Develop and prepare highly complex reports and provide and/or interpret information and data across divisions and departments

Keywords: data, mining, analytics, claims, audit 

Required Qualifications:
- Undergraduate degree required
- Recent experience in a position focusing on data reporting and analysis required.
- 3 years of healthcare industry experience to include healthcare claims and member data knowledge required.
- Experience with healthcare performance measurements required.

Assets:
- Knowledge of SAM (Smart Audit Master) system including edit rule logic
- Knowledge of CCM (Claims Cost Management)
- Proficiency in MS Office (Word, Excel, Outlook, PowerPoint, Access)
- Proficiency with MS Visio
- SAS, Base SAS, SAS EG
- Devlin
- Experience with UHG Data Warehouses Data Marts and/or Platforms

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.