Senior Healthcare Data Consultant, Payment Model Implementation - Remote Location: United States Job category: OptumInsight Consulting Primary location: Washington D.C., DC Overtime status: Exempt Travel: No Job Description: Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably.For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. Optum Serve Consulting/The Lewin Group (OSC/Lewin), a premier national health care and human services consulting and policy analysis firm, brings 50 years of experience finding answers and solving problems for leading organizations in the public, non-profit, and private sectors. In the wide-ranging field of health human services consulting, OSC/Lewin provides both depth and breadth of expertise. Currently, OSC/Lewin has more than 300 consultants drawn from industry, government and academia. They all share a solid commitment to OSC/Lewin's core values of objectivity, integrity, analytical innovation, vision, and dedication to client satisfaction. At OSC/Lewin, we help federal, state, and other decision-makers strengthen health and human services programs, make informed policy choices, and implement critical initiatives. The Senior Consultant will provide support on a number of payment model implementation contracts including leading operations support, analytics, and policy analysis. In collaboration with current staff across the organization, the Senior Consultant will work to provide unparalleled client service, produce the highest quality deliverables, and innovate across the market.From a relationship and business growth perspective, s/he will support the development of new client relationships, attaining new contracts, and broadening the firm's work. 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. Schedule: Monday - Friday, daylight shift in your time zone Primary Responsibilities: - Engage, develop, and cultivate existing client relationships through policy consultation and thought leadership - Lead payment model operations and technical assistance activities, including oversight of analytics to inform model operations, for value-based care initiatives - Support the development of payment calculations, conduct financial and trend analysis, calculate quality metrics, and perform fast-paced ad-hoc analysis to quickly address client needs - Mentor other staff to develop their technical and analytical problem-solving skills - Maintain a consistently high degree of accuracy and attention to detail in all tasks - Work effectively and cooperatively as a member of a project team - Efficiently query large databases of healthcare claims and eligibility data - Perform a broad range of quantitative analysis to inform the design, implementation, and evaluation of Medicare and Medicaid payment models 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: - 6+ years of experience using SQL, R, Python, or SAS in a research, consulting, or business environment - 4+ years of experience working on federal health policy issues, including Medicare and Medicaid value-based payment, working in multiple areas serving as a subject matter expert - Experience translating complex findings to non-technical audiences in both written and verbal contexts - Experience successfully leading cross-functional project teams - Experience working on implementing or evaluating value-based payment programs - Experience working in Snowflake or Databricks environments Preferred Qualifications: - Experience supporting multi-year payment model implementation contracts - Experience with databases having complex structures and relationships, such as the Integrated Data Repository, Chronic Conditions Warehouse, or similar data environment *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. OptumCare 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.

Title: Education Specialist Location: United States Job Description: The Weitzman Education Specialist will work closely with the Weitzman Institute Education core and is responsible for the project management of Weitzman Institute education interventions related to the Weitzman Education department. Weitzman Education has three core areas of focus – health professions, continuing education, and system transformation. Education interventions including Weitzman ECHO, learning collaboratives, webinars, technical assistance, consultation, and other innovative interventions. The Weitzman Education Specialist is a key member of various education teams responsible for needs analysis, development, design, implementation and evaluation of educational interventions for health professions’ residents and students, primary care providers, care team staff, and clinical, operational, and executive leaders in primary care and other health care organizations. Specific responsibilities include project management for a variety of educational interventions in various stages of planning and implementation; work with faculty to develop and enhance didactics and other educational materials; engagement with participants involved in the various interventions to build and maintain learning communities; tracking and monitoring of operational data including continuing education, survey administration, data collection; data analysis and reports for continual improvement of education interventions; software use for tracking participation of learners, organizations, faculty, and education materials, such as case presentations, video recordings, and other educational materials; and participation in proposal development, grant writing, poster presentations, and publications. Delivery methods for educational interventions include video conferencing, video recordings, site visits, and in-person/virtual consultations. III. REQUIRED QUALIFICATIONS - Minimum of a Bachelor’s degree, preferably in a health-related field - 1-3 years of work experience, preferably in a health-related field and/or with project support experience - Proficiency in Microsoft Office and internet-related applications, survey software, and database software - Ability to support implementation of detailed project plans, coordination and communication among contributors and stakeholders, and delivery of projects within the approved time, budget, and objectives. - Strong organizational skills and attention to detail. - Strong communication, time-management and prioritization skills, ability to multi-task, and interpersonal skills. - Ability to work cooperatively with team members, providers, and agencies. - Ability to work independently and meet deadlines. - Ability to recommend actions to enhance the success of Weitzman Education program initiatives. - Experience in leveraging technology and business partners to deliver content. - Outstanding written and oral communication skills. - Demonstrated problem solving skills, including the ability to plan and implement in a fast-paced environment. - Ability to prioritize multiple tasks and organize work effectively. - Current Driver’s license and ability to travel in and out of state - IV. SIGNIFICANT JOB RESPONSIBILITIES - Responsible for session arrangements and maintenance for various education interventions. - Providing clerical, organizational, and technical support for participants and faculty. - Supporting the recruitment of participants (students, residents, providers, care team staff, leaders) and organizations and tracking admissions/enrollment/graduation. - Recording and maintaining education intervention data: attendance, didactics, case presentations, didactic schedule via web-based program, evaluation surveys. - Administering surveys and assisting with data collection and analysis to maintain quality of education programs. - Assisting with onboarding of new learners to educational programs including conducting technology tests and providing technical support as needed. - Developing engaging and attractive presentations for a number of venues including conferences. - Supporting coordination and project management on cross-Weitzman initiatives, as requested or needed. - Coordinating or managing the development of new education programs, such as assisting with onboarding new faculty members and participants, creating case forms, and marketing materials. - Organizing and communicating with faculty in all of their responsibilities including didactic curriculum planning, case review, faculty meetings, content development, participant demographics, continual improvement. - Facilitating regularly scheduled faculty meetings. - Supporting senior staff with grant development and reporting, which may include writing parts of the grant applications or reports, brainstorming elements of a work plan, coordinating with partner organizations for letters of support, and proofreading for grammar and format. - Working with the senior staff to manage grant deliverable timelines. - Creating operational reports for external funders and supporting with other deliverables. - Assist with creating content for marketing purposes in collaboration with CHC’s Communications team including eBlasts, newsletters, printed collateral, and maintaining/updating assigned Weitzman Education webpages. - May be assigned to attend conferences to exhibit, present, and/or teach about Weitzman Education programs. - Providing support to Weitzman Education leadership on accreditation efforts. - Professional responsiveness and adaptability to rapid change. - Building constructive and effective relationships both internally and externally. - Other duties as assigned. - V. COMMUNICATION SKILLS Excellent oral and written skills are required. This position is highly involved with staff, providers, clients, colleagues, outside vendors and community. VI. CONFIDENTIALITY OF INFORMATION Confidentiality of business information is a requirement. Confidentiality must be maintained according to CHC policies. This Position is available for remote work. Organization Information: The Moses/Weitzman Health System is a global leader addressing challenges faced by organizations caring for the poor and diverse populations, and is home to programs focusing on education, research, and process improvement support for safety net providers. The system delivers primary care to more than 150,000 patients in Connecticut, and extends access to specialty care for more than 2.5 million individuals across the U.S. It is a national accrediting body for organizations training advanced practice providers, and offers accredited education and training for Medical Assistants in multiple states.

Role Description The AR Management Specialist will provide support across all aspects of insurance and patient billing to ensure prompt and accurate payment to the client or provider for all monies owed by both patients and insurers. - Make telephone calls to patients, hospitals, insurance companies, facilities, and attorneys as needed to research claims or obtain additional insurance information. - Contact insurance carriers to inquire about the status of past-due accounts. - Meet or exceed defined productivity and quality standards. - Document details of activity on each account in the claims processing system. - Follow up on self-pay accounts, including contacting patients by telephone to inquire about insurance coverage or establish payment plans. - Maintain workflow to keep aging accounts at a minimum by following up on unpaid claims daily. - Follow up on accounts that have reached collections to ensure they have been fully worked before referral to an external collection agency. - Follow up on any assigned special projects designated by the Manager. - Perform quality checks on assigned claims. - Maintain confidentiality regarding all assignments. - Perform job responsibilities and tasks according to company standards, as well as state and federal guidelines. - Demonstrate the highest level of compliance with all laws and regulations, including but not limited to HIPAA. - Ensure consistent adherence to company attendance policies. - Additional job duties as assigned. Qualifications - High School Diploma or equivalent required. - Minimum of 1 year of experience in healthcare claims processing, billing, or accounts receivable. - Hands-on experience preparing and submitting insurance appeals, including understanding remittance advices, payer denial codes, and payer timely filing limits. - Familiarity with ICD-10, HCPCS, and general medical terminology. - EMS billing experience strongly preferred; experience in other medical specialties will be considered. - Proficiency with various web platforms, including billing software and payer portals. - Prior customer service experience with the ability to work collaboratively with other departments and team members. - Basic computer knowledge and experience using Microsoft Office. - Strong customer service skills and experience. - Strong interpersonal, organizational, communication, and time-management skills. - Strong investigative and research skills, with the ability to resolve complex billing issues. - Effective critical thinking and analytical abilities. - Ability to work independently in a fast-paced, adaptive environment with minimal supervision. - Ability to independently manage all aspects of the job role including required goals and business practices in a remote environment. Benefits - Competitive salary, commensurate with experience. - Comprehensive benefits package, including 401(k) Plan.

At PwC, our people in business application consulting specialise in consulting services for a variety of business applications, helping clients optimise operational efficiency. These individuals analyse client needs, implement software solutions, and provide training and support for seamless integration and utilisation of business applications, enabling clients to achieve their strategic objectives. As an Oracle lead to revenue at PwC, you will focus on working with Oracle's suite of applications and tools designed to manage the entire customer journey, from lead generation to revenue realisation and customer satisfaction. You will be responsible for implementing and configuring Oracle lead management, sales automation, marketing automation, and customer experience solutions to meet the specific needs of an organisation. Enhancing your leadership style, you motivate, develop and inspire others to deliver quality. You are responsible for coaching, leveraging team member's unique strengths, and managing performance to deliver on client expectations. With your growing knowledge of how business works, you play an important role in identifying opportunities that contribute to the success of our Firm. You are expected to lead with integrity and authenticity, articulating our purpose and values in a meaningful way. You embrace technology and innovation to enhance your delivery and encourage others to do the same. Examples of the skills, knowledge, and experiences you need to lead and deliver value at this level include but are not limited to: Analyse and identify the linkages and interactions between the component parts of an entire system. Take ownership of projects, ensuring their successful planning, budgeting, execution, and completion. Partner with team leadership to ensure collective ownership of quality, timelines, and deliverables. Develop skills outside your comfort zone, and encourage others to do the same. Effectively mentor others. Use the review of work as an opportunity to deepen the expertise of team members. Address conflicts or issues, engaging in difficult conversations with clients, team members and other stakeholders, escalating where appropriate. Uphold and reinforce professional and technical standards (e.g. refer to specific PwC tax and audit guidance), the Firm's code of conduct, and independence requirements. The Opportunity As part of the Business Application Consulting team, you are responsible for the Oracle Lead to Revenue initiatives, focusing on enhancing processes and improving client satisfaction. As a Manager, you are responsible for guiding teams in strategic planning and execution, supporting project success and maintaining elevated standards. You are responsible for leveraging your knowledge in Oracle and delivering Oracle Utilities Meter to Cash Billing Applications. Responsibilities - Maintain exemplary standards and successful project outcomes - Engage in strategic planning and execution to achieve business objectives - Foster a culture of continuous improvement and innovation - Develop and mentor team members to enhance their skills - Maintain and uphold the firm's quality standards and ethical guidelines What You Must Have - Bachelor's Degree - 6 years of experience What Sets You Apart - Master's Degree preferred - Managing Lead-to-Revenue cycle processes - Understanding multiple business monetization models - Experience with Oracle CX solutions - Knowledge of global compliance and regulatory requirements - Analyzing Lead-to-Revenue processes for improvements - Deliver Oracle Utilities Meter to Cash Billing Applications - Aligning Oracle strategies with digital transformation initiatives The salary range for this position is: $99,000 - $232,000. Actual compensation within the range will be dependent upon the individual's skills, experience, qualifications and location, and applicable employment laws. All hired individuals are eligible for an annual discretionary bonus. PwC offers a wide range of benefits, including medical, dental, vision, 401k, holiday pay, vacation, personal and family sick leave, and more. To view our benefits at a glance, please visit the following link: https://pwc.to/benefits-at-a-glance As PwC is an equal opportunity employer, all qualified applicants will receive consideration for employment at PwC without regard to race; color; religion; national origin; sex (including pregnancy, sexual orientation, and gender identity); age; disability; genetic information (including family medical history); veteran, marital, or citizenship status; or, any other status protected by law. PwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy. Learn more about how we work: https://pwc.to/how-we-work For only those qualified applicants that are impacted by the Los Angeles County Fair Chance Ordinance for Employers, the Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, San Diego County Fair Chance Ordinance, and the California Fair Chance Act, where applicable, arrest or conviction records will be considered for Employment in accordance with these laws. At PwC, we recognize that conviction records may have a direct, adverse, and negative relationship to responsibilities such as accessing sensitive company or customer information, handling proprietary assets, or collaborating closely with team members. We evaluate these factors thoughtfully to establish a secure and trusted workplace for all. Applications will be accepted until the position is filled or the posting is removed, unless otherwise set forth on the following webpage. Please visit this link for information about anticipated application deadlines: https://pwc.to/us-application-deadlines #LI-Hybrid #BI-Hybrid