Optum · 15 hours ago
Senior Advisory Services Consultant - Remote
United States
Full-time
Remote
Mid, Senior Level
$90K/yr - $161K/yr
4+ years expOptum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. This position will be responsible for scoping, analysis, and delivery of analytics-oriented projects, focusing on improving health outcomes and supporting analytics service delivery within the Medicaid domain.
EducationHealth CareMedicalPharmaceutical
Responsibilities
Support analytics service delivery within the Medicaid domain by providing deep analytic and implementation support of payment methodologies based on claims and policy-based definitions across Commercial, Medicare, Medicaid, and Life Science domains
Specific projects may include developing client reimbursement benchmarks, hospital margin analytics, CMS new technology application support, and development and ongoing maintenance of episodic value-based payment models and other analytic projects
Translate documented requirements into solutions using the appropriate tools/processes (e.g., business use cases, process flows, application configuration workbooks)
Assist in the maintenance and support of the Normalized Pricing and Prometheus products, including product releases and updates and collaboration with different teams to synchronize the algorithm across various platforms
Complete data intake and processing of large CMS datasets for use in both standardized and ad-hoc client projects as well as tracking of developments from CMS related to claims pricing systems (DRG, APC, HCPCS)
Provide data analytics processing support according to project specifications either individually or through collaboration with other subject matter experts
Provide support to customers for Normalized Pricing and Prometheus products, including supporting product implementation and consultation, making recommendations, performing pricing, analyzing, and explaining results, identifying issues, and providing solutions
Organize and communicate results to customers in the form of spreadsheet reports and other analytic outputs including data visualization
Partner with applicable stakeholders to identify and implement operational efficiencies and assess the operational impact of changes within defined solutions (e.g., changes to policies/procedures, compliance with applicable legal/regulatory requirements, additional requirements)
Engage in the development of new products and solutions to enhance revenue growth opportunities
Qualification
Required
4+ years working with and analyzing health care data. Must be familiar with claim structure, data components and relationships that contribute to reimbursement
4+ years of SQL experience, preferably in MS SQL Server environment with knowledge of database maintenance, ETL, and experience with complex scripts
2+ years of experience with CMS Prospective Payment frameworks and / or reimbursement methodologies including DRG, APC, RBRVS, Per Diem, etc
Preferred
Experience with SAS
Intermediate to Advanced Proficiency level of skill in Excel
Proven solid communication skills and attention to detail. Must have the ability to communicate effectively with all audiences (technical to senior leadership)
Proven excellent data quality assessment skills. Must be able to leverage knowledge of UB and CMS claims to quickly identify problems within a submitted claims dataset
Proven excellent data analysis skills and a demonstrated ability to assess patterns, trends, and behaviors within large health care claims populations
All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Benefits
Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution
Company
Optum
Optum is a healthcare company that provides pharmacy services, health care operations, and population health management. It is a sub-organization of UnitedHealth Group.
10001+ employees
H1B Sponsorship
Optum has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (648)
2024 (559)
2023 (620)
2022 (851)
2021 (593)
2020 (438)
Funding
Current Stage
Late StageLeadership Team
Daniel Castillo
Chief Executive Officer, Optum Care Delivery
J
Jay Green
Chief Financial Officer
Recent News
2025-11-29
2025-11-19
2025-11-07
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