UnitedHealth Group Medical Director Payment Integrity Ideation-Telecommute in Houston, Texas
Optum Payment Integrity is focused on innovating new ideas and leveraging technology to detect and remediate overpayments and underpayments through the enforcement of previously established contracts and regulatory standards. We are committed to controlling the cost of healthcare and to our mission of helping people live healthier lives.Primary Responsibilities: Identifying new medical cost savings opportunities related to reimbursement or payment policy and coding guidelines with an annual savings target Providing clinical perspective to clients and Optum teams developing new cost containment concepts Engaging with stakeholders across the organization to advance Payment Integrity policy related ideas and strategies and obtain client approval to deploy solutions for proposed or active policies Being a subject matter expert in clinical matters representing Payment Integrity with the ability to develop expertise in new areas Supporting external business and product development Embodying in our words and actions the United Healthgroup culture built on the pillars of relationships, compassion, integrity, performance, and innovation Ensuring the right service at the right time at the right level of care for each particular member is rendered Travel required - up to 50% Join Optum Payment Integrity where you will help reduce health care cost and improve outcomes in the healthcare system while doing your life’s best work.(sm) Required Qualifications: MD or DO degree Active unrestricted physician state license Current board certification in ABMS or AOA specialty 5+ years of clinical practice experience post residency Strong understanding of and concurrence with evidence-based medicine (EBM) and managed care principles, as well as familiarity with current medical issues and practices Foundational windows based computer skills, including typing, word processing, presentation, and spreadsheet applications, as well as internet research skills. Experience interpreting and developing medical or reimbursement policies and an understanding of certificate of coverage language Familiarity with inpatient and outpatient claim coding issues Strong clinical intuition allowing for inferences to be drawn from data Familiarity with pharmacy and behavioral health aspects Professionally-appropriate written vocabulary and grammar skills, including the ability to modify for different audiencesPreferred Qualifications: Hands-on utilization and / or quality management experience Mentoring and coaching experience Project management or active project participation experience Excellent presentation skills for both clinical and non-clinical audiences Substantial experience in using electronic clinical systems Proposal and business case development experience 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) 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. 52b143aa-7754-4a02-b12a-c17bba908a70
Medical Director Payment Integrity Ideation-Telecommute Minnesota-Eden Prairie 679619