Payment Integrity Ideation Associate Director Outpatient Facility Coder - Remote

Optum; Minnetonka (MN); Remote; USD 106,000 - 195,000; Full time

Job summary

An established industry player is seeking a skilled professional to join their team in a role focused on improving healthcare cost efficiency. This position involves analyzing utilization and costs, developing cost-saving initiatives, and collaborating with internal stakeholders to enhance payment integrity. The ideal candidate will have a strong background in coding and auditing within the healthcare sector, along with exceptional analytical skills. This role offers the flexibility to work remotely from anywhere in the U.S., providing a unique opportunity to make a significant impact on health equity and outcomes for diverse communities. Join a culture that values diversity, innovation, and collaboration.

Benefits

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Qualifications

• 3+ years of experience in coding with certifications.
• 4+ years of experience auditing and billing claims.

Responsibilities

• Identify and develop cost savings initiatives for clients.
• Perform analytical work to support concept development.

Skills

Outpatient Reimbursement

Claims Auditing

Coding (COC, CCS, ROCC, RHIA, RHIT)

Data Analysis

Stakeholder Engagement

Education

Advanced degree in health care or medical field

Tools

Excel

PowerPoint

Tableau

Visio

Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Positions in this function research and investigate key business problems through quantitative analyses of utilization and healthcare costs data. Provides management with statistical findings and conclusions. Identifies potential areas for medical cost improvements and alternative pricing strategies. Provides data in support of actuarial, financial and utilization analyses.

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

Primary Responsibilities:

• Identify, create, and develop a portfolio of cost savings initiatives that drive specific and measurable results for assigned clients while providing timely and meaningful client updates


• Perform and participate in iterative analytical, experimental, investigative, and other fact-finding work in support of concept development


• Establish strong matrixed relationships with internal stakeholders to define, align, and deliver payment integrity initiatives in support of assigned clients


• Influence senior leadership to adopt new ideas, approaches, and/or products


• Recommend changes to current product development procedures based on market research and new trends


• Industry thought leader and subject matter expert for medical claims, related trends, pricing, and cost management initiatives


• Lead concepts/projects from conceptualization to completion

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Coding certification --- COC, CCS, ROCC, RHIA, or RHIT with a minimum of 3 years post-certification experience


• 4+ years of experience in Outpatient Reimbursement


• 4+ years of experience auditing, billing, and/or coding claims within a Payment Integrity domain


• 4+ years of experience in the health care industry (Medicare, Medicaid, Commercial) with deep exposure to Payment Integrity or Revenue Integrity


• 3+ years of post-certification experience Outpatient Specialty Surgeries and Procedures


• 3+ years of work experience in highly collaborative and consultative roles, with ability to establish credibility quickly with all levels of management across multiple functional areas


• 2+ years of experience performing research and analysis of claims data and applying results to identify trends/patterns


• 2+ years of experience presenting proposals to stakeholders and internal customers


• Maintains working knowledge of CMS rules and regulations and billing codes and related services

Preferred Qualifications:

• Advanced degree in health care or medical field


• 3+ years of experience in claims adjudication or revenue cycle management


• 2+ years of experience working in a matrixed and highly adaptive environment handling tight deadlines


• Solid computer skills: Excel (Pivot Tables, Advanced Formulas, macros, etc..), Visio, PowerPoint, Tableau

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

The salary range for this role is $106,800 to $194,200 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with al minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.