Market Monitoring Build out and develop analytics monitoring (and ideally forecasting) competitor pricing strategies across both traditional competition and market disruptors Monitor and forecast trends of drug acquisition costs over time Monitor and forecast trends of brand drug costs over time Assess, evaluate and predict the impact of market events (new drugs to market

Bring traditional actuarial skills to provider organizations as the health care market continues to evolve, including Assist in developing innovative strategies, value based contracts, and innovative risk based arrangements Develop, conduct, and evaluate studies on pricing, utilization, and health care costs for our broad range of provider clients Prepare, forecast, and a

Provide presentations and demonstrations to customers and prospects of our products after thorough discovery incorporating value statements and benefits to Physicians, Administrators, Clinical Staff and C Level Executives Provide staffing and participation in product areas for tradeshows and product fairs Strategize with the Sales Team on a strategy to win Provide trainin

Understand edits and appropriate department procedures to effectively submit and/or correct errors on claims to the production standards of the department Utilize various resources such as third party publications, procedure manuals and participating contractual agreements, etc. to reconcile accounts Advanced knowledge and understanding to process third party rejections u

Project Management Lead small to medium size client projects intended to design and develop analytics that offer financial insights in the pharmacy domain. This includes charter development, planning, financials, issue and risk management, scheduling, and other logistics in quality delivery Operations Management Serve as the teams operations lead supporting sales pipeline

Setting annual budget and providing ongoing financial analysis of development and operational results against the budget Perform financial analysis to support the management of the business to include real estate, utilization of providers and provider hiring, and medical management cost, and other ad hoc analysis Perform full P&L financial modeling to support FP&A month e

Provide administrative support in a manner consistent with the highest level of performance and professionalism while building effective relationships with other administrative assistants; operate as a team player and provide back up support as needed Maintain and update calendars; manage incoming scheduling requests, prioritize and communicate with all parties Coordinate

Help process provider applications and re applications including initial mailing, review and loading into the database tracking system Conduct audits and provide feedback to reduce errors and improve processes and performance Demonstrate great depth of knowledge/skills in own function and act as a technical resource to others Solve complex problems on own; proactively ide

Supervision of inpatient Hospital bill coding, responsible for DRG and ICD 10 PCS procedure code assignment Ensures functions performed in accordance with system wide policies, procedures, and governing organizations Defines individual and team goals Monitors staff and department performance and productivity levels and proposes ways to improve effectiveness, efficiency, a

Ensures charges are captured in an appropriate and timely manner. Reviews, calculates, and enters charges in the electronic medical record (EMR). Examines financial reports for accuracy edits. Processes and completes charge entry. Ensures charges are compliant with federal regulations. May assist with audits. Work with hospitals, clinics, facilities and the clinical team

Identify and develop strategic opportunities to enhance client satisfaction and drive business growth Formulate and execute strategies to ensure client compliance with Federal and State regulations governing Medicare and Medicaid programs Collaborate with subject matter experts (SMEs) to develop tailored Medicare strategic initiatives, including initiatives related to STA

Collaborate with executive leaders and business units to identify and understand their reporting and analytics needs, ensuring alignment with organizational goals. Manage the deployment of cloud based data solutions and business intelligence tools to enhance reporting capabilities and support data driven decision making. Design and develop efficient data pipelines, data w

Develop, perform and manage the analyses of business and financial metrics as well as performance measures for all capital and other labor costs within OptumRx Information Systems Develop and maintain financial reports to clearly communicate actual results, forecasted performance, and variances to plan, forecast and budget for $300M in annual spend Develop, perform and ma

Focus on implementation and operational aspects of assigned Optum markets utilizing Cozeva Act as a liaison between Optum markets, Cozeva (Vendor) and other stakeholders (data teams, health plans) Leads complex projects that require cross functional coordination Responsible for issue management and facilitate solutioning to improve Cozeva adoption Create, maintain and com

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 diversity and inclusion, talented peers, c