This position will serve our customers with clinical fraud detection advice and provide onsite software training for customers. The incumbent will develop and validate the final proofs used during User Acceptance Testing and conduct weekly internal training classes for staff analysts serving our customer accounts.
******* May offer a flexible schedule to accommodate commuting schedule and eligible to telecommute one day a week after a year of employment. ********
Responsibilities will include:
Organizes, sorts and filters data in order to distinguish patterns and recognize trends
Develops and maintains data preparation and validation routines to support data mining
Selects, recommends and applies appropriate analytic and statistical methodologies and techniques to execute against an analysis plan or research objectives
Serve as point of contact with our customers for questions and software issues
Prepare and conduct annual Users' Meeting for our customers
Provide clinical, fraud and business application guidance to development team
Publish customer newsletter of recent frauds (marketing service)
Create detailed clinical specification documents for our technical staff to build algorithms.
What makes your technology career greater with UnitedHealth Group? You'll have the most opportunities to grow and develop. We invest in rich technology resources and talented people to help glean and use intelligence in ways that drive quality and affordability of healthcare for millions of people worldwide. It's your chance to be a transformational force in the industry and within UnitedHealth Group. If you believe there is always a better way, take the next step in exploring your potential with UnitedHealth Group.
OptumInsight is one of the largest and fastest growing health information companies. We specialize in improving the performance of the health system by providing analytics, technology and consulting services that enable better decisions and results. We integrate workflow solutions that deliver data in real-time, and create actionable insights - processing health information that relates directly to and affects one in four patients in the U.S, one in every three Medicaid dollars and one in every five emergency room visits. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.What can YOU do with the right information? At OptumInsight, the possibilities and the impact are limitless. No matter what your role is at OptumInsight, you'll be empowered to ask more questions, develop better solutions and help make the health care system greater than ever. It's always fresh. It's always exciting. And it's never been more important.
Must have clinical license; RN, LPN, LCSW, LMSW, LPC, PT, OT or possess similar clinical degree
At least 4-5 years experience in healthcare fraud and abuse detection
Comfotable learning and using software
Intermediate to Advanced user of Word, Excel, and other software tools
Able to travel to customer sites10% of the time, and present and train groups of users clearly and articulately
In-depth knowledge of all types of health care claims (institutional, pharmacy, professional, dental, etc.)
Basic knowledge of statistics
Additional Preferred Assets:
Data processing development experience
Nursing or clinical background
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/VUnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
RN, LPN, PT, OT, Clinical, Registered Nurse, Atlanta
UnitedHealth Group - 18 months ago
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