Senior Advisory Services Consultant - Remote

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.

By delivering solutions across spectrums of health care Optum is focused on our aspiration of improving experiences and outcomes for everyone we serve while reducing the total cost of care. In support of this, Optum Insight's purpose is to connect the health care system with trusted services, analytics and platforms that make clinical and administrative processes valuable, easy, and efficient for everyone.

Optum Insight provides analytics, research, consulting, technology and managed services solutions to hospitals, physicians, health plans, government agencies, life science companies, and other industry partners. In addition to our many commercial clients, Optum Insight capabilities and technologies are leveraged by Optum Health, Optum Rx and our sister company United Healthcare.

This position will be responsible for scoping, analysis, and delivery of analytics-oriented projects. Qualified candidates will possess a solid understanding of value-based payment and reimbursement methodologies and concepts that include APC, DRG, Per Diem, RBRVS, etc. Candidates should also have experience working with large medical claims data sets and be familiar with how to quickly identify issues with claims data quality.

Candidates should be able to work independently and collaboratively in a matrixed team environment and possess solid critical thinking solution-oriented skills.

You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

• Support analytics service delivery within the Medicaid domain by providing deep analytic and implementation support of payment methodologies based on claims and policy-based definitions across Commercial, Medicare, Medicaid, and Life Science domains
• Specific projects may include developing client reimbursement benchmarks, hospital margin analytics, CMS new technology application support, and development and ongoing maintenance of episodic value-based payment models and other analytic projects
• Translate documented requirements into solutions using the appropriate tools/processes (e.g., business use cases, process flows, application configuration workbooks)
• Assist in the maintenance and support of the Normalized Pricing and Prometheus products, including product releases and updates and collaboration with different teams to synchronize the algorithm across various platforms
• Complete data intake and processing of large CMS datasets for use in both standardized and ad-hoc client projects as well as tracking of developments from CMS related to claims pricing systems (DRG, APC, HCPCS)
• Provide data analytics processing support according to project specifications either individually or through collaboration with other subject matter experts
• Provide support to customers for Normalized Pricing and Prometheus products, including supporting product implementation and consultation, making recommendations, performing pricing, analyzing, and explaining results, identifying issues, and providing solutions
• Organize and communicate results to customers in the form of spreadsheet reports and other analytic outputs including data visualization
• Partner with applicable stakeholders to identify and implement operational efficiencies and assess the operational impact of changes within defined solutions (e.g., changes to policies/procedures, compliance with applicable legal/regulatory requirements, additional requirements)
• Engage…