Develop and optimize Tableau dashboards, write and manage SQL code for data pipelines, perform ad-hoc analysis to support decision-making, and ensure data accuracy through validation and monitoring in healthcare analytics initiatives.

Analyze financial protection products to assess risk, prepare financial modeling for client strategies, and manage business renewals focusing on profitability while delivering competitive proposals to support growth.

Title: Prepay Coding Consultant Location: Plymouth United States Job Description: 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. This position is full-time, Monday - Friday. Employees are required to work our normal business. It may be necessary, given business need, to work occasionally overtime or weekends. We offer weeks of paid on-the-job training. The hours during training will be 8:00am to 5:00pm CST, Monday - Friday. Training will be conducted virtually from your home. You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Utilize resources and reference materials (e.g., on-line sources, manuals) to identify appropriate medical codes and reference code applicability, rules and guidelines - Apply understanding of relevant medical coding subject areas (e.g., diagnosis, procedural, evaluation and management, ancillary services) to assign appropriate medical codes - Apply understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable medical codes - Utilize medical coding software programs or reference materials to identify appropriate codes - Apply relevant Medical Coding Reference, Federal, State, and Professional guidelines to assign and record independent medical code determinations - Manage multiple work demands simultaneously to maintain relevant productivity and turnaround time standards for completing medical records (e.g., charts, assessments, visits, encounters) - Provide information or respond to questions from medical coding quality audits - Educate and mentor others to improve medical coding quality - Demonstrate basic knowledge of the impact of coding decisions on revenue cycle - Attain and/or maintain relevant professional certifications and continuing education seminars as required - All other duties as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: - High School Diploma/GED - Certified Coder with credentials from AAPC with a CPC or AHIMA with CCS, RHIT, RHIA - 3+ years of CPT & ICD coding experience (surgical, hospital, clinic settings) - Intermediate level of proficiency with PC based software - Ability to work our normal business hours of 8:00am - 5:00pm, Monday - Friday. It may be necessary, given the business need, to work occasionally overtime or weekends - Must be 18 years of age OR older Preferred Qualifications: - AHFI or CFE certification - Licensed Registered Nurse (RN) - Licensed Practical Nurse (LPN) - Experience in a production environment - Experience with one or more of the following: - Claim processing - Provider demographic information - Insurance billing practices Soft Skills: - Ability to prioritize and manage multiple tasks - Proven ability to work in a team setting - Excellent oral and written communication skills and presentation skills - Critical thinking, problem solving and analytical skills - All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $23.89 to $42.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN

Title: Clinical Quality Consultant - Oncogenetic Program - Remote Primary location: Dallas, TX Additional locations: Minneapolis, Minnesota | New York, New York | Los Angeles, California | Miami, Florida | Atlanta, Georgia | Houston, Texas | San Antonio, Texas | Seattle, Washington Requisition number: 2353640 Job category: Medical & Clinical Operations Overtime status: Exempt Travel: No Job Description: 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. The Clinical Quality Consultant for the Oncogenetic Program provides guidance and support for utilization management related to advanced molecular and genetic testing in oncology. This role ensures evidence-based decision-making, compliance with regulatory standards, and optimal patient outcomes through expert interpretation of genomic data and collaboration with multidisciplinary teams. The position requires experience in molecular pathology and oncogenetics, combined with demonstrated collaboration skills and the ability to thrive in a fast-paced, technology-driven environment. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Work to improve quality and promote evidence-based medicine - Ensure the right service is provided at the right time for each member - Work with medical director teams focusing on inpatient care management, clinical coverage review, member appeals clinical review, medical claim review and provider appeals clinical review 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: - PhD degree in molecular pathology, genetics, or similar - 5+ years of clinical experience in oncology or genetic medicine - Experience with genomic data interpretation software (e.g., NextGen sequencing analysis tools) - Knowledge of regulatory and compliance standards (CMS, NCCN, ASCO guidelines) for genetic testing and oncology care - Familiarity with molecular diagnostic coding systems and claims platforms - Proficiency in interpreting next-generation sequencing (NGS) and other advanced molecular diagnostic technologies - Proven ability to work effectively in a fast-paced, technology-driven environment - Proven ability to review work performed by others and provide recommendations Preferred Qualifications: - Hands-on utilization and/or quality management experience - Experience in using electronic clinical systems - Proven to serve as a key resource on complex molecular diagnostic cases - All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $112,700 to $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.