Job description


  • Entry level
  • No Education
  • Salary to negotiate
  • Franklin


Position Description

No industry is moving faster than health care. And no organization is better positioned to lead health care forward. We need attention to every detail with an eye for the points no one has considered. The rewards for performance are significant. You'll help improve the health of millions. And you'll do your life's best work.(sm)
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Research potential overpayment scenarios through the use of client policies and provider contracts, seeking to identify overpaid claims used to build recurring algorithms
Identify and refine criteria to successfully build and enhance new and existing algorithm logic ensuring correct claim payment
Research and quickly Identify patterns of claim payment abnormalities through big data analysis
Develop metrics to forecast new algorithm profitability
Write business requirement documents for new algorithms and update existing documents as the algorithm logic is developed or changes over time
Maintenance existing production algorithms to maximize performance while working directly with the programmers to test and implement changes
Facilitate new algorithm kick off calls and training with our matrix partners
Monthly analysis of algorithm performance; forecasted vs. actuals
Provide management weekly reports outlining work completed and issues encountered
Lead special projects with little to no manager supervision or assistance
Breakdown complex problems into individual root causes

Required Qualifications:
Associate Degree
1+ years of experience working healthcare claims lifecycle (ie: submission, processing, adjudication, and payment)
Proficient with excel to include pivot tables, foundational formulas, charts, etc.
In-depth knowledge of claims processing
Ability to detect data anomalies through the use of large data sets
Preferred Qualifications:
Bachelor’s Degree
AHIMA or AAPC certification
Previous leadership experience
LEAN or Six Sigma experience
Strong communication skills
Outgoing and able to effectively engage with internal clients (employees and leaders within other areas of the business)
Comfortable working in a high-paced production area
Analytical mindset with critical thinking skills
Excellent time management and prioritization skills in order to meet multiple deadlines       
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)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and 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 Analyst, Healthcare Economic Consultant, Sr Business Analyst, Optum, telecommute, telecommuter, remote, work from home

Job Details
Requisition Number
Job Title
Healthcare Economic Consultant - Telecommute
Job Family
Business Segment
Optum Operations
Job Location Information

Franklin, TN
United States
North America
Additional Job Detail Information

Employee Status
Job Level
Individual Contributor
Day Job
Telecommuter Position
Overtime Status

About the company

Our mission is to help people live healthier lives and to help make the health system work better for everyone.

A Fortune 6 company, we're focused on helping people live healthier lives while making the health system work better for everyone. Here, we seek to empower people with the information, guidance and tools to make personal health choices. We work harder and we aim higher. We expect more from ourselves and each other. And, at the end of the day, we’re doing a lot of good for more than 85 million people worldwide.

Our biggest point of differentiation is our people - and the collective talent, energy, intelligence and drive our force of 188,000 individuals around the world bring to our mission every single day. So, how do we do it? With our every action, interaction and intention that demonstrates the five fundamental values that guide everything we do:

• Integrity
• Compassion
• Relationships
• Innovation
• Performance

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