Senior Healthcare Economic Analyst – Franklin, TN - Full-time / Part-time

What makes your career greater with UnitedHealth Group? Growth opportunities among the variety of product lines and making an impact on the healthcare system ensures it will always be challenging and exciting.

The Senior Healthcare Economic Analyst will be responsible for working in conjunction with Data Analysts to identify new trends, develop, test and implement new production audit opportunities.  Focus on driving productivity and quality of algorithm outputs to allow identification staff to achieve and exceed monthly goals.  Develop, collect and analyze metrics and data to formulate fact-based decisions and proactively implement process improvements.  Use metrics, excellent time management skills and leadership skills to ensure business objectives and goals are met.

The Coordination Of Benefits Advanced Analytic Lab's primary focus is on member investigations relating to identification of other insurance including Medicare and other commercial payers. This team investigates trends in Health Care data related to member demographics and or claim information to detect other insurance primacy leveraging the pre and post pay claim data sets and eligibility indicators.

Experience in statistical analysis, healthcare claims payment and membership eligibility review, and knowledge of government healthcare programs are strong attributes for candidates in this position.

** This role is based in Franklin, TN**

Requirements.

• Strong financial analysis skills and knowledge of statistical calculation and interpretation

• Possess excellent time management and prioritization skills in order to meet multiple deadlines; comfortable working in a high-paced/high production area

• Certification of Medical coding preferred, or 1- 2 years of extensive coding experience.

• 1 - 2 years of Coordination of Benefits auditing experience

• Bachelor's degree or equivalent experience.

• High degree of proficiency in Access, Excel, Word, PowerPoint

• SAS/SQL experience a plus

• Payer experience/knowledge a plus

• NAIC Guidelines knowledge required

• Medicare reimbursement methodology required

• Ability to maintain understanding of numerous client processes

• Leadership skills

• Excellent critical thinking skills

• Detail oriented

• Excellent written and verbal communication skills.

• Self-driven, ability to work independently and facilitate change

• Undergraduate degree strongly preferred

Keywords: Medicare, COB, NAIC, analysis, data

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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.