Associate Director Payment Integrity - Telecommute
Company: UnitedHealth Group Inc.
Posted on: June 8, 2021
Tough challenges? We know a thing or two about those. When
you're on a mission to help people live healthier lives, the stakes
couldn't be higher. As an Associate Director Payment Integrity, you
will help rewrite the future of the health care system. You'll
analyze data and deliver bold, business-savvy ideas to impact the
lives of millions. Along with ground-breaking challenge, you'll
have the support and resources of a Fortune 7 company. Join us.
You'll enjoy the flexibility to telecommute* from anywhere
within the U.S. as you take on some tough challenges.
- Implementation and management of Payment Integrity
- Ability to lead a team of Payment Integrity associates across
multiple Payment Integrity Pillars, and Care Delivery Organizations
(CDOs) to meet departmental savings goals
- Analyze, review, forecast and trend complex data, reviewing the
analysis and interpretation of others' work
- Develop and implement effective / strategic business solutions
through research and analysis of data and business processes
- Support short- and long-term operational/strategic business
activities through analysis
- Manage working relationships with multiple payment integrity
- Maintain and track performance tracking and savings reports to
- Build out departmental and incremental savings goals
Are you up for navigating a complex matrix of business units and
teams? We share a near obsessive desire to outperform and outdo our
own achievements across our entire global business landscape. It's
going to take all you've got to create valuable solutions to
improve the health care system.
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.
- Undergraduate Degree or equivalent work experience
- Experience working as a leader, with direct reports
- 5+ years of experience in the health care industry, in
auditing, claims processing, payment integrity, claims
- 4+ years of experience using claims platforms such as UNET,
Pulse, NICE, Facets, Diamond, etc.
- 2+ years of experience conducting or managing comprehensive
research to identify billing abnormalities, questionable billing
practices, irregularities, and fraudulent or abusive billing
- Experience with Fraud, Waste, & Abuse (FWA) programs, or
working within a Special Investigations Unit (SIU)
- Proficiency in performing financial analysis / audit including
statistical calculation and interpretation
- Proficiency in various claims payment methodologies; to include
capitation, fee-for-service, DRG, percent-of-charge, and OPPS
- Proficiency using Microsoft Office: Word, Excel (data analysis,
sorting / filtering, pivot tables), PowerPoint (prepare formal
presentations and training), Visio (develop workflow
- Experience with public speaking and presenting to large
audiences, including Executives and Medical Directors
- Experience interpreting provider contractual agreements
- If you need to enter a work site for any reason, you will be
required to screen for symptoms using the ProtectWell mobile app,
Interactive Voice Response (i.e., entering your symptoms via phone
system) or a similar UnitedHealth Group-approved symptom screener.
Employees must comply with any state and local masking orders. In
addition, when in a UnitedHealth Group building, employees are
expected to wear a mask in areas where physical distancing cannot
- Undergraduate degree or Masters
- Experience working with federal contracts
- 1 or more of the following certifications: CPC, CPCO, AHFI,
- CES (Claims Editing System) SME, or SME in another clinical
claims editing system
- Experience with product and vendor implementations
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)
Colorado Residents Only: The salary range for Colorado residents
is $94,500 to $171,700. Pay is based on several factors including
but not limited to education, work experience, certifications, etc.
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.
- 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: payment integrity, pillars, Fraud, Waste, & Abuse
(FWA), Special Investigations Unit (SIU), Telecommute, Remote, Work
Keywords: UnitedHealth Group Inc., Minnetonka , Associate Director Payment Integrity - Telecommute, Other , Minnetonka, Minnesota
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