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Job Information

UnitedHealth Group Senior Healthcare Economics Consultant - Telecommute in Tampa, Florida

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

OptumCare is a rapidly growing business with a strong physician group footprint across the country impacting multiple lines of business – Commercial, Medicare and Medicaid. As the Senior Healthcare Economics Consultant, your primary responsibility will be centered around payer and provider relationships in support of OptumCare’s value-based growth.

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

Primary Responsibilities:

  • Support OptumCare transition to value-based care across all markets, payers, and products

  • Support OptumCare pre-risk activities including, but not limited to identification, documentation and communication of new value-based arrangement details across all markets payers and products

  • Collaborate with national leadership to establish and execute contracting initiatives and objectives, identifying and prioritizing areas of focus

  • Identify, share and execute best practices (e.g., provider roster management, quality program components, and overall value-based contract components) with national and regional colleagues

  • Design efficient and effective solutions for challenging problems ranging from small to large complex work efforts. Support change management for existing processes and develop standard processes where they do not exist

  • Build strong relationships within the organization including financial, actuarial, network contracting and clinical operations areas

  • Create, maintain, and present collateral on various topics

  • Create and maintain an inventory of payer and provider quality and TCOC incentives

  • Serves as the team Quality/HEDIS SME

  • Conduct adhoc analysis which includes comparing, merging, validating, and summarizing multiple and or large data sets. These data sets should be used for tracking and presenting solutions for identified business problems.

Candidate should have demonstrated ability working within cross-functional teams and working with senior leadership. Successful candidates will have strong people, project, change, data management and presentation skills. Candidate should also have demonstrated ability to work, without precedence, in a matrix environment and lead through influence, as well as a history of improving results. The ideal candidate will be able to:

  • Assess and interpret customer needs and requirements

  • Work with less structured, more complex issues

  • Solve moderately complex problems and/or conduct moderately complex analyses

  • Work with minimal guidance; seek guidance on only the most complex tasks

  • Identify solutions to non-standard requests and problems

  • Translate concepts into practice

  • Provide explanations and information to others on difficult issues

  • Acts as a resource for others with less experience

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:

  • Bachelor’s degree in a relevant field or equivalent experience

  • 3+ years of experience in provider contracting

  • 3+ years of experience in provider incentives to include a combination of modeling, reporting and performance assessment

  • Basic level knowledge of claims processing and guidelines

  • Basic level of knowledge of network access and adequacy

  • Demonstrate understanding of applicable product strategy as well as payer and provider reimbursement terms for different lines of business (e.g., Medicare; Commercial & Medicaid preferred)

  • Advanced level of proficiency with Excel, PowerPoint, Word, Visio & Tableau

  • Sound knowledge of the Medicare market and products

  • Sound knowledge of CMS STARs/HEDIS

Preferred Qualifcations:

  • Experience with UHG systems including UDW, UNET, Galaxy, MDE and UGAP

  • Experience in SQL/SAS/Tableau

  • Solid verbal and written communication skills

  • Demonstrated self-motivation and initiative

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

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, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $82,100 to $146,900. The salary range for Connecticut / Nevada residents is $90,500 to $161,600. 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.