Sr Consultant, Healthcare Reimbursement Analytics - Telecommute

UHG Minnetonka, MN

About the Job

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)


We are looking for an experienced Healthcare Reimbursement Analyst as an addition to the Network Analytics Consulting Practice in Optum Advisory Services. This position will be responsible for scoping, analysis and delivery of analytics oriented projects. Qualified candidates will possess a strong understanding of reimbursement methodologies and concepts that include APC, DRG, Per Diem, RBRVS, etc. Candidates should also have experience working with large medical claims datasets, be familiar with how to quickly identify issues with claims data quality and possess exceptional analytical skills.


You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.


Primary Responsibilities:

  • Develops deep knowledge of consulting product and analysis methodologies
  • Analyzes customer claims data to ensure that content provided by customers will support scope of work and to identify underlying issues within submitted content.
  • Processes data according to project specifications either individually or through collaboration with other consulting subject matter experts
  • Devises analytic methodologies to deliver creative and meaningful results for our customers
  • Organizes and communicates results to customers in the form of data sets, reports and/or presentations
  • Engages in the maintenance of existing and development of new products and solutions to enhance revenue growth opportunities
  • Works directly with customers throughout the lifecycle of a project

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.

Required Qualifications:

  • Bachelor’s degree in Health Sciences, Computer Science, Analytics, or Business
  • 2+ years of experience working in some capacity with reimbursement methodologies (e.g. APC, DRG, Per Diem, etc.)
  • 3+ years of experience working with and analyzing health care data, mainly UB (facility) and HCFA (professional) claim form content. Familiar with claim structure, data components and relationships that contribute to reimbursement
  • 2+ years of SQL experience, preferably in SQL Server environment (Experience with select, table joins, ability to read and understand SQL code and stored procedures)
  • 2+ years of Excel experience (ie. experience with pivot tables, function such as VLOOKUP, percentile calculations, basic statistical features (e.g. histograms, percentiles, etc.))
  • Excellent data quality assessment skills. Must be able to leverage knowledge of UB and HCFA claims to quickly identify problems within a submitted claims dataset
  • Excellent data analysis skills and a demonstrated ability to assess patterns, trends and behaviors within large health care claims populations
  • Excellent data presentation skills. Must be able to develop formatted reports using MS Office tools that are presentable to customers (mainly Excel, Powerpoint and Word)

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: OptumInsight, Reimbursement Methodologies, Medicare APC/DRG, Analyze Claim Data, UB, HCFA, SQL, Excel, Reimbursement Methodologies, telecommuter, telecommuting, work from home, telecommuting, wfh, travel, remote