Senior Consultant Business Systems

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.  

Primary Responsibilities:

• Development and updates of charter and project plans, including scope, high-level requirements, assumptions, constraints and milestones
• Responsible for meeting minutes and agenda
• Manage and track work across various matrixed delivery partners
• Apply analytical / technical approach to problem solving
• Knows how to obtain and use data, and comfortable with statistical concepts related to project management delivery
• Utilize one's strong interpersonal skills to work with all levels of management across all functional areas, as well as business partners through internal entities
• Work within client ticketing system to track escalated issues, input new issues or answer issues sent in by other teams. Supports matrixed delivery methods from resource internal or external to Optum PPS
• Work independently to determine and document Client PPS payment system impact items
• Works directly with customers to define other project requirements, aid and answer questions related to business and or product needs
• Engage with dedicated clients either VPN or Remote, WebEx to apply updates or Troubleshoot issues using product documentation from Regulatory Portal
• Support Optum Business Partners with questions around software and payment systems
• Compile Documentation: Processes and Procedures (including but not limited to technical impact items in the product release cycles, operational needs or deficiencies based on client needs)
• Exhibit flexibility to ensure seamless collaboration, timely responsiveness, and continuity of service in support of client needs

• Assist as needed with other Client Support Projects

• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Required Qualifications:

• 7+ years of experience working in a healthcare data or regulatory environment
• 7+ years of experience analyzing and solving customer problems
• Experience acting as a liaison between business and technical teams
• Experience to interpret and breakdown down technical information, aligning to client specific impact items for awareness
• Experience with EasyGroup, Payment System Interface (PSI), Web.Strat and Rate Manager
• Experience pricing Medicare hospital facility claims (inpatient and outpatient)
• Experience breaking down information and developing solutions
• Experience documenting client operational and technical workflow
• Experience configuring and customizing software solutions
• Some Facility claims reimbursement experience - Medicare, Medicaid, Commercial
• Exposure to healthcare claims data, basic PPS concepts, UB04 and HCFA 1500 claim content
• Basic knowledge and understanding of Prospective Payment Systems - includes DRG, APC, OCE, ESRD, CAH, CMG, RUG, RBRV
• Demonstrated competency in large-scale organizations within a matrix environment
• Demonstrated ability to communicate ideas clearly and concisely to leadership
• Demonstrated ability to prioritize and balance multiple demands and competing deadlines

Preferred Qualification:

• Experience with Microsoft Word, Excel, PowerPoint, Visio

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.