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Director, Payment Integrity Laboratory & Genomics Program - Telecommute

Company: UnitedHealth Group
Location: Eden Prairie
Posted on: January 12, 2022

Job Description:

Some people take things as they come. Others relentlessly push themselves to go farther. As a thought leader you thrive on developing new solutions to solve tough challenges. A R&D position at UnitedHealth Group offers you an unmatched place to develop your career among a diverse group of businesses driven by the power and stability of a leading health care organization. It's a combination you won't find anywhere else. As the Director, Payment Integrity Laboratory & Genomics Program, you will serve as a labs services subject matter expert and manage a mix of transformational projects to drive incremental medical cost savings for our clients. This is the challenge of a lifetime. Come help us reduce fraud, waste, and abuse for lab related services as you do - your life's best work.(sm)

The Laboratory & Genomics Program team within Payment Integrity is looking for a dynamic leader with proven research and business acumen to join the team as a Director Healthcare Economics to act as the principal analytic lead for complex and cross team analyses of laboratory & genomic health strategies within the commercial, fully insured business. The successful candidate will act as a driving force for the development, deployment and measurement of tactical and strategic plans of action related to the team's two core functions:
Develop, deploy, and support cost saving analytics using your subject matter expertise and data analysis to identify right member, right time and right program
Evaluate the effectiveness, efficacy and efficiency of our clinical programs using rigorous methods and advanced statistics

The position is well suited for an individual who enjoys variety in their work since our work spans the full spectrum of disease states, health events, and health services (i.e., medical, behavioral, and pharmacogenomic). Come join us as we tell the public health value story of UnitedHealthcare.

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

Primary Responsibilities:
Well-developed understanding of epidemiologic, pharmacoeconomic, and health services research design and methods, including the application of advanced statistics to evaluate economic, clinical and humanistic outcomes of clinical interventions
Recognized predictive analytics and data science leader with a proven ability to derive value from data and information, driving enterprise-wide strategic and tactical applications for a Fortune 10 company
Extensive experience with the strategic design and application of population health strategies to improve health and well-being, with a particular focus on clinical programs targeting individuals with a complex constellation of disease or advanced illness
Proven ability to determine, demonstrate and communicate the value of interventions designed to improve health outcomes, reduce health disparities, and increase the cost benefit of health care
Established record of successful design and deployment of strategies to identify and mitigate adverse cost and utilization trends based on a broad knowledge of the healthcare environment
Recognized reputation for strong, collaborative relationships with internal and external customers to build trust, identify needs and ensure commitments and satisfaction
Highly proficient in the use and application of administrative, clinical, and survey data and reporting infrastructures required to efficiently and effectively monitor utilization, cost, quality and satisfaction trends, including root cause analysis
Maintain and manage a portfolio of projects aimed at controlling lab related medical cost with an annual incremental savings target
Research new lab services fraud, waste, and abuse scenarios. - Orchestrate quantitative analysis of claim data, derive savings estimates, and create business cases to justify new projects
Oversee projects from conceptualization to solution deployment
Cultivate relationships with and seek the support of business partners who are capable of Labs concept ideation and those who participate in governance/concept approval activities
Develop a formal Labs Payment Integrity capability that is comprehensive and differentiated in the industry developing a holistic perspective on scenarios that may result in lab claim overpayments

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:
5+ years of experience working in a Lab setting with expertise or experience in a minimum of four of the following lab disciplines: Blood Banking, Microbiology, Chemistry, Immunology, Hematology, and Clinical Microscopy, OR working for a Payer in a role with exposure to lab service claim payment and/or labs related policy development
5+ years of experience with data reporting and analysis
5+ years of progressive leadership experience including leading operations and/or business processes
3+ years of experience performing research and analysis of claims data and applying results to identify trends/patterns
An advanced level of proficiency working with MS Office. - For Excel specifically including advanced formulas, pivot tables, macros, lists, statistical functions, etc.
Demonstrable Project Management skills
Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all -federal, state -and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to -employment to ensure compliance
Preferred Qualifications:
Bachelor's Degree / Master's Degree
Proficiency with SQL, SAS and/or other statistical programs
An understanding of claim adjudication processes and reimbursement policies
An ASCP credential beyond Phlebotomy Technician certification
Established record of peer-reviewed publication
Ability to manage competing priorities, make decisions, and effectively execute across a large, global fast-paced organization
Experience managing a comprehensive portfolio of program
Certified Professional Coder (CPC)
Solid consulting and influencing skills; proven results as a performance consultant; ability to identify root causes, and determine solutions
Able to present your ideas to key leaders and clientele
Proven track record of translating findings into actionable information to support business decisions

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination 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)

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Colorado, Connecticut or Nevada Residents Only : The Salary -range for Colorado residents is -$110,200 to $211,700. -The Salary -range for Connecticut/Nevada residents is -$110,200 to 211,700. -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

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: Director, Payment Integrity Laboratory & Genomics Program, Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote

Keywords: UnitedHealth Group, Eden Prairie , Director, Payment Integrity Laboratory & Genomics Program - Telecommute, Executive , Eden Prairie, Minnesota

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