Sr Advisory Services Consultant - Remote

MedStar Health; Eden Prairie (MN); Remote; USD 89,000 - 161,000; Full time

Job summary

A leading healthcare organization is seeking a Sr Advisory Services Consultant to drive analytics-driven projects focused on healthcare reimbursement. This role involves analyzing healthcare data, ensuring data quality, and collaborating with clients to enhance reimbursement methodologies. With remote work flexibility, this position offers a chance to shape health outcomes through strategic data insights.

Benefits

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase options

401k contribution

Qualifications

• 3+ years of experience with health care data analysis.
• 3+ years of SQL experience in MS SQL Server.
• 1+ years of experience with CMS payment frameworks.

Responsibilities

• Lead analysis of healthcare reimbursement projects.
• Conduct claims and policy-based analytics.
• Develop reimbursement benchmarks and support clients.

Skills

Health care data analysis

SQL

Communication skills

Data quality assessment

Data analysis

Excel

Education

Bachelor's degree in relevant field

Tools

SAS

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Sr Advisory Services Consultant leads the scoping, analysis, and execution of analytics-driven projects focused on healthcare reimbursement. The ideal candidate will demonstrate deep knowledge of reimbursement methodologies-including APC, DRG, Per Diem, and RBRVS - and possess experience working with large medical claims datasets, including identifying and resolving data quality issues. Success in this role requires solid analytical and problem-solving skills, as well as the ability to work independently and collaboratively within a matrixed team environment.

Key responsibilities include conducting claims and policy-based analytics to support Commercial, Medicare, Medicaid, and Life Sciences clients. Projects may involve developing reimbursement benchmarks, analyzing hospital margins, and supporting CMS new technology applications. The role also entails processing large CMS datasets for both standardized and ad-hoc analyses, monitoring regulatory updates related to pricing systems (e.g., DRG, APC, HCPCS), and contributing to the maintenance of the Normalized Pricing product. Additional duties include supporting product implementation, performing pricing analyses, troubleshooting issues, and delivering clear, actionable insights to clients. The position also plays a role in enhancing existing products and developing new solutions to drive business growth.

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

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:

• 3+ years working with and analyzing health care data. Must be familiar with claim structure, data components and relationships that contribute to reimbursement


• 3+ years of solid SQL experience, preferably in MS SQL Server environment with knowledge of database maintenance, ETL, and experience with complex scripts


• 1+ years of experience with CMS Prospective Payment frameworks and / or reimbursement methodologies including DRG, APC, RBRVS, Per Diem, etc.

Preferred Qualifications:

• Experience with SAS


• Proven solid communication skills and attention to detail. Must have the ability to communicate effectively to all audiences (technical to senior leadership)


• Proven excellent data quality assessment skills. Must be able to leverage knowledge of UB and CMS claims to quickly identify problems within a submitted claims dataset


• Proven excellent data analysis skills and a demonstrated ability to assess patterns, trends and behaviors within large health care claims populations.


• Intermediate to advanced proficiency level of skill in Excel

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

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.