Senior Consultant – Telecommute

UnitedHealth Group
November 20, 2021
Atlanta, GA
Job Type


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's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

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

Primary Responsibilities:

  • Payment Integrity Data Analytic Support: Apply analytical / quantitative approach to problem solving 
  • Knows how to obtain and use data, and comfortable with statistical concepts 
  • Utilize communication skills to influence and negotiate 
  • Utilize one’s solid interpersonal skills to work with all levels of management across all functional areas, as well as, business partners through internal entities 
  • Provider Reimbursement support: Researching, compiling, interpreting, documenting, developing appropriate specifications for, testing and deploying custom pricing solutions 
  • Work directly with Optum colleagues and customers to determine and document reimbursement or product training and education needs  
  • Delivering customer training and education programs 
  • Conducting regulatory research to determine revisions/updates to various federal and state Medicaid payment 
  • systems and updating the appropriate library of education materials to reflects current rule and regulations 
  • Works directly with customers to define other project requirements, provide assistance to answer questions related to project outcomes 
  • Assist as needed with other claims pricing projects 


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 or 2+ years of experience with EasyGroup, Web.Strat or Rate Manager 
  • 5+ years or experience working in a healthcare data or regulatory environment 
  • Basic knowledge and understanding of Prospective Payment Systems - may include DRG, APC, OCE, ESRD, CAH, ASC, SNF, HHA, LTC, IPF, IRF, FQHC, Hospice, Professional claims 
  • Experience pricing Medicare hospital facility claims (inpatient and outpatient) 
  • Experience breaking down information and developing solutions 
  • Health plan or payment integrity experience in facility contract configuration, claims operations or IT 
  • Experience documenting client operational and technical workflow 
  • Experience configuring and customizing software solutions 
  • Facility claims reimbursement experience - Medicare, Medicaid, Commercial 
  • Solid understanding healthcare claims data, basic PPS concepts, UB04 and HCFA 1500 claim content, EDI, 837i/837p 
  • Ability to conduct research on varying federal and states Medicaid regulations to determine hospital, ambulatory surgery, and physician provider reimbursement rules 
  • Demonstrate excellent data management and data quality skills 
  • Experience with Microsoft Word, Excel, PowerPoint, Visio 
  • Travel 30% of the time 
  • 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:       

  • Experience with EasyGroup, Web.Strat or Rate Manager 
  • Experience with Optum CES 
  • SQL experience - write queries, load tables, build output file 
  • .NET or IIS experience 
  • Claims system knowledge - Trizetto Facets, NetworX Pricer, QNXT, Health Rules Payer, IKA Claims, Burgess Systems, Epic Tapestry, 3M 
  • Experience with Tableau 

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 $79,700 to $142,600. The Salary range for Connecticut/Nevada residents is $87.900 to $156,900. 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: Senior Consultant, Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote

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