Sr. Clinical Expense Analyst (New Opportunity/Telecommute!!)

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.



UnitedHealthcare, a UnitedHealth Group company, provides network-based health and well-being benefits and services for employers and consumers nationwide. We use our strength, diversity and innovation to improve the lives of the more than 18 million people who receive our unique products and services. And our endless pursuit for excellence in everything we do extends to your career as well. Join us today for an inspired and purposeful mix of professional growth opportunities and personal rewards.


 


If you’re interested in a position that offers excellent potential for advancement, plus the chance to be part of a new team that is a key component of our company’s strategy for the future, consider applying to join us as a Sr. Clinical Expense Analyst. Telecommuting from anywhere in the U.S., you would initiate, implement and drive the execution of changes that will result in cost savings. Four positions available!


 


Primary responsibilities include:


Identifying and quantifying current and emerging affordability opportunities

Driving the development and execution of affordability action plans within each market

Managing the consequential action plans to ensure that the results meet or exceed expectations

Reporting on results obtained and forecasting for future impacts

Integrating and coordinating local action plans with all of the national programs that comprise the Total Affordability Management agenda

Reviewing and interpreting claims pay data and epithetic data and interpreting to develop conclusions regarding medical expenses

Making recommendations for improvement of medical expense data

Reviewing data trends, variation and other data points to identify opportunities to improve medical costs

Conducting further investigation and forwarding information to the fraud and abuse team when needed

Acting as a leader and mentor for Claims Analysts

Serving as the lead for all Medical Expense management process intervention activities



Significant clinical experience is required, as is a degree/license in Nursing OR a master’s degree in Healthcare Economics. Proven leadership and project management skills will also be essential. Prior experience in the clinical analysis of medical costs, and in presenting clinical data to management, will also be needed. Superior negotiation skills and a background that includes driving and implementing change throughout an organization would be preferred. Knowledge of data retrieval systems, including Report Net, is mandatory.

 

UnitedHealth Group offers a full range of comprehensive benefits, including medical, dental and vision, as well as a matching 401k and an employee stock purchase plan.

 

If you are interested in growing professionally within an innovative, highly respected organization, we invite you to explore this excellent growth opportunity!

 

Diversity creates a healthier atmosphere:  equal opportunity employer M/F/D/V.