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in Eden Prairie, MN

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Hours Full-time, Part-time
Location Eden Prairie, MN
Eden Prairie, Minnesota

About this job

Some people take things as they come. Others relentlessly push themselves to go farther. Combine health care and technology, which are two of the fastest-growing fields on the planet, with UnitedHealth Group's culture of performance, collaboration and opportunity and this is what you get: industry-leading health care services at a company that's improving the lives of millions. As the Health Care Economics Consultant you will design and develop reports and analyze data to measure clinical outcomes, network performance and methodology levers. You will investigate key business problems through quantitative analyses of utilization and health care costs data. As the Consultant, you will interpret and analyze clinical data from various sources and recommend best approaches for its consolidation. Your analyses will be used to create viable, real-world solutions in a complex health care landscape. The work is as challenging as it is rewarding. You'll open doors to new opportunities. This is where bold people with big ideas are writing the next chapter in health care. Join us. There's never been a better time to do your life's best work.(sm)


 


Join the Optum Performance Monitoring team as a Healthcare Analytics Consultant! You will work on performance monitoring projects for the Advanced Analytics Lab. This requisition is to fill a position in support of Performance Monitoring for our Fraud Analytics area. 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 analytic metrics, the analysis of results and the identification of opportunities for false positive reduction in order to increase client savings and improve operational efficiency.


 


Primary focus area is the detection and prevention of fraud, waste and abuse for professional and facility claims, through the rules-based analytics. These rules maximize claim payment accuracy, overpayment recovery, and education of our provider community. To ensure optimal performance and accuracy, existing rules are refined based on performance feedback and to adhere to regulatory compliance for updated code sets.


 


Primary Responsibilities:



  • 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

  • Research complex functional issues using a variety of resources

  • Develop and prepare highly complex reports and provide and/or interpret information and data across divisions and departments

  • Assume responsibility for data integrity among various internal groups and/or between internal and external sources

  • Provide source system analysis

Requirements

Required Qualifications:



  • Undergraduate degree or equivalent experience

  • Recent experience in a position focusing on data reporting and analysis to include root cause analysis

  • 3+ years of healthcare industry experience to include healthcare claims and member data knowledge

  • Experience with healthcare performance measurements

  • Experience developing code and performing data extraction with SAS

Preferred Qualifications:



  • Proficiency in MS Office (Word, Excel, Outlook, PowerPoint, Access)

  • Proficiency with MS Visio

  • SQL experience

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, 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.


 


Job Keywords: data analysis, SAS, claims, trends, mid-level health care economics job, math, reporting, quantitative analysis, health care, SQL, analytics, programming, economics, telecommute