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Consultant jobs at Highmark - 22 jobs

  • Change Execution Consultant

    Highmark Health 4.5company rating

    Consultant job at Highmark

    This job plays a key role in ensuring projects (i.e. change initiatives) meet objectives on time and on budget by increasing employee adoption and usage of the change solution. The incumbent focuses on the people side of change - including changes to business processes, systems and technology, job roles and organization structures. Creates and implements change execution strategies and plans that maximize employee adoption and usage and minimize risk to implementation. Works to drive faster adoption, higher ultimate utilization and greater proficiency of the changes that impact employees in the organization to increase benefit realization, value creation, ROI and the achievement of results and outcomes. While this job does not have supervisory responsibility, the incumbent works through many others in the organization to succeed. Acts as a coach for senior leaders and executives in helping them fulfill the role of change sponsor. May also provide direct support and coaching to frontline managers and supervisors as they help their direct reports through transitions. Supports project teams in integrating change execution activities into their project plans. **ESSENTIAL RESPONSIBILITIES** + Apply a structured change methodology and lead change management activities.This involves partnering with sponsors and project managers to create actionable change management deliverables: (e.g. communications plans, sponsor roadmap, management coaching plans, training plans, resistance management plans, etc.).Integrate change management activities into overall master project plan.Consult and coach project teams in value and integration of change management with project management.Support development and execution of communications strategies and plans to build necessary commitment.Support development and execution of training efforts. + Complete change management assessments (e.g. risk, sponsorship, capacity, etc.).Identify key stakeholders who play role in organizations commitment to change.Assess the change impact on individuals and organizations and capacity to execute change.Support change execution capability building across the organization (leaders, managers, program/project leaders, front-line employees, etc.). + Create and execute a change management strategy.Partner with senior leadership to obtain and maintain sponsorship.Identify, analyze, and prepare risk mitigation tactics.Identify and manage anticipated resistance.Define and measure success metrics and monitor change progress. + Assess organizational culture to identify consistency with change and gaps that need to be addressed.Work with leadership to mitigate culture barriers by advising on action plans.Follow through to measure and track results. + Work directly with change sponsors and leaders and multiple levels to help strengthen their sponsorship skills.Evaluate and ensure user readiness for change.Train sponsors, project leaders, and stakeholders on change methodology.Coach managers and supervisors in preparing organization and staff for change. + Track and report issues to successful change implementation and realization.This includes report outs to senior leadership, project owners, stakeholders, and project sponsors. + Other duties as assigned. **EDUCATION** **Required** + Bachelor's Degree in Business Administration/Management, Industrial Psychology, Organizational Behavior Studies or related field **Substitutions** + 6 years of relevant work experience in healthcare, project management, change management and/or business analysis in lieu of a Bachelor's Degree **Preferred** + Master's Degree in Business Administration/Management, Industrial Psychology, Organizational Behavior Studies or related field **EXPERIENCE** **Required** + 5 years in Consulting + 5 years in Strategic Planning/Corporate Development **Preferred** + None **LICENSES AND CERTIFICATIONS** **Required** + None **Preferred** + Prosci Certification + Certified Change Management Professional (CCMP) **SKILLS** + Change Management + Leading Change + Organizational Change Management + Relationship-builder with Unsurpassed Interpersonal Skills + Flexibility + Analysis of business problems/needs + Stakeholder Management + Business Strategy + Program Management + Training Delivery **Language (Other than English)** None **Travel Required** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-Based Teaches / trains others regularly Constantly Travel regularly from the office to various work sites or from site-to-site Occasionally Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $78,900.00 **Pay Range Maximum:** $147,500.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273828
    $78.9k-147.5k yearly 26d ago
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  • Senior Change Management and Process Improvement Consultant

    Highmark Health 4.5company rating

    Consultant job at Highmark

    ***This will be a hybrid role if you live within a 50 mile radius a Highmark Office** This senior-level job will lead and facilitate integrated process improvement and change management initiatives across multiple functional units Responsibilities encompass designing and implementing process optimization strategies, developing and executing comprehensive change management plans across all impacted stakeholders throughout the change lifecycle, coaching leaders and teams as applicable, and ensuring seamless alignment between people, process, and technology solutions - all while directly contributing to successful business outcomes and ongoing improvements. The successful candidate will leverage expertise in Lean Six Sigma, as well as change management methodologies to drive efficiency, effectiveness, and improved business outcomes. **ESSENTIAL RESPONSIBILITIES** + Process Improvement and Change Management Planning & Execution: Define, prioritize, and implement process improvements aligned with product roadmaps and strategic objectives, mitigating change impact through needs assessments, opportunity identification, planning improvement implementation, and considering the effect on product development and delivery. + Consultative Process Optimization & Stakeholder Management: Provide expert consultation to stakeholders, leveraging Lean, Six Sigma, Agile, and other methodologies to optimize workflows, enhance productivity, reduce costs, and accelerate delivery. This includes conducting change impact assessments, stakeholder management, and risk mitigation. + Cross-Functional Collaboration & Change Implementation: Collaborate with cross-functional teams to implement changes, ensuring alignment with strategy, addressing resistance, and managing transitions smoothly. This involves supporting integration of improvements into systems, conducting change impact assessments, and identifying/addressing organizational culture barriers and their impact on timelines. This includes conducting change impact assessments, stakeholder management, and risk mitigation. + Process Improvement Implementation & KPI Development: Develop and implement process improvement solutions, including KPIs and control mechanisms, while partnering with stakeholders (product managers, owners, technical teams) on change management best practices and fostering change sponsorship. Deliver targeted training on process changes and the change management process itself. + Process Standardization, Monitoring & Reporting: Drive the development and implementation of consistent product development process standards across the organization, tracking progress and reporting to senior leadership. This includes defining and monitoring success metrics to measure the impact of process improvements and change management efforts on key performance indicators. + Process Improvement & Change Management Capability Building: Support the growth of process improvement and change management skills and capabilities within the organization, contributing to the evolution of process standards and enhancing the organization's change management capabilities. + Other duties as assigned or requested. **EXPERIENCE** **Required** + 5 years in Change management and/or operational excellence role + 3 years in Operations role **Preferred** + 3 years in Product management or related enabling role **SKILLS** + Proven experience in both change management and process improvement roles, with a demonstrable track record of successful project delivery. + Strong understanding and experience applying Lean, Six Sigma, Agile, and other process improvement methodologies. + Proficiency in change management methodologies (e.g., Prosci, etc) + Excellent analytical, problem-solving, and decision-making skills. + Strong communication, presentation, and interpersonal skills, with the ability to influence and motivate stakeholders at all levels. + Experience developing and delivering training programs. + Experience with business process modeling tools and techniques and Agile project management tools (e.g., Jira). **EDUCATION** **Required** + Bachelor's degree or relevant experience and/or education as determined by the company in lieu of bachelor's degree. **Preferred** + Master's degree in Business Administration/Management or any applicable advanced degree **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + Change Management Methodologies (ie. Prosci etc) + Lean Six Sigma **Language (Other than English):** None **Travel Required:** Less than 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-Based or Remote Position **Physical work site required** Frequently **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $78,900.00 **Pay Range Maximum:** $147,500.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273830
    $78.9k-147.5k yearly 26d ago
  • Strategy Consultant - Risk Adjustment

    Highmark Health 4.5company rating

    Consultant job at Highmark

    This job supports executive leadership of the Organization with a range of strategic initiatives, specifically focusing on the evolution of Risk Adjustment Accuracy Management (RAAM) and Highmark's clinical data strategy. Providing analytical/strategic-thinking and leading project teams, particularly those bridging business and technical functions, to: 1) isolate complex business issues related to RAAM and interoperability; 2) design and execute analytics for studying these issues (market research, scenario planning, forecasting, etc.); 3) develop technical content and serve as a subject matter expert on clinical data exchange, interoperability standards, and related technologies; 4) support development of formal recommendations to senior levels of Highmark leadership, ensuring solutions maximize business value and adhere to technical standards; 5) create documents (go-to-market or operational strategies, technical roadmaps, etc.) that inform critical strategic issues and decisions, and 6) execute the initiatives. **If you are within 50 miles of a Highmark office this role will be Hybrid onsite 3 days a week. T, W, Th. If you are outside of those 50 miles this role will be remote.** **ESSENTIAL RESPONSIBILITIES** + Work with business/ market owners to identify key business issues, apply right analytical framework, develop solution and recommendations, represent findings to stakeholders and own the outcome. + Manage major strategy projects with the help of internal or external strategy consulting resources. + Serve as subject matter expert to Strategic Operations staff and stakeholders on membership, growth and operational strategy issues. + Provide periodic informal work guidance/direction to junior team members; Provide performance input and recommendations to management for development/ training plans. May have supervisory responsibilities on a project basis. + Develop analytical frameworks, approach and methodology best practices to analyze strategy issues. + Other duties as assigned or requested. **EDUCATION** **Required** + Masters Degree in Business, Healthcare, Economics or related degree + 2 years of post-grad experience with strategy / management consulting firms (such as McKinsey, Boston Consulting Group, Booz & Company, Accenture (strategy Practice) or Deloitte (Strategy practice) ) or internal strategy groups of healthcare companies (such as Aetna, United Health Group, WellPoint, GE, ) + 6 years of related experience in Business or Healthcare **Substitution** + Bachelor's degree and 3 years of relevant progressive strategic experience in lieu of Master's degree **Preferred** + Extensive knowledge of Health Insurance and/or Provider operations, especially related to Risk Adjustment. + Experience in operational improvement and process optimization. **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + None **SKILLS** + Strong analytical and problem-solving skills. + Strong PC application Skills (MS Office including PowerPoint and Excel). + Knowledge of healthcare industry trends and challenges, especially in the context of interoperability. + Hands-on experience working with and applying clinical data standards (FHIR, CDA, HL7, etc.). + Experience leveraging data integration technologies and cloud platforms to address business needs. + Proficiency in gathering and facilitating the translation of business requirements into technical requirements. + Strong knowledge of healthcare IT security and privacy regulations (e.g., HIPAA). + Strong critical thinking skills. + Good communication and presentation skills across various audience levels. **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Never Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Never Lifting: 25 to 50 pounds Never **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $92,300.00 **Pay Range Maximum:** $172,500.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273804
    $92.3k-172.5k yearly 3d ago
  • Senior Clinical Product Strategy Consultant/Pharmacist

    Highmark Health 4.5company rating

    Consultant job at Highmark

    This job requires the incumbent to balance clinical and business acumen to implement and provide ongoing support and oversight of assigned pharmacy programs. This pharmacist will work in a team-oriented environment as a subject matter expert of assigned pharmacy program offerings with both clinical and non-clinical focus. The incumbent is responsible for implementation, market introduction, overall performance, and continuous improvement of their assigned programs. The incumbent will work with internal partners and leadership to develop a firm grasp of the Organization's clinical program strategy as it evolves over time to enhance the value that is delivered to the Organization's customers. ESSENTIAL RESPONSIBILITIES + Define the Organization's clinical product eminence strategy and plan, including the identification of key activities (e.g., conferences, publications, white papers, webinars, etc.) that will help to reinforce the Organization's leadership position in the marketplace for clinical products/services. + Execute the eminence strategy and plan, including serving as the the Organization's liaison for activities (e.g., conferences), managing logistics (e.g., webinars), and developing content required to support activities (e.g., presentations); pull in resources from across the enterprise to support execution of plan as needed. + Conduct market scans to stay abreast of health trends and research; educate leadership on key findings for sharing with account teams, as well as functional leadership (e.g., product, clinical area). + Participate in the health policy review process, providing the clinical product strategy perspective. + Inform competencies of distributed clinical product resources, identifying learning needs, and inform performance management process. + Partner with analytics to develop insights supporting the development and sharing of eminence (e.g., white papers, health policy reviews, etc.). + Partner with public relations to share pilot "success stories" externally, helping the Organization to be viewed as innovative in the clinical product space. + Act as the subject matter expert (SME) for assigned programs and related workflows, including those with high complexity + Function independently as business SME during assigned program implementations, expansions, and enhancements + Ensure ongoing state and federal compliance of assigned programs, in concert with legal, product, and ER&G matrix partners + Development and maintenance of accurate marketing materials for assigned programs + Provide written and verbal education on assigned programs to internal stakeholders. + Other duties as assigned or requested. REQUIRED EDUCATION + Bachelor's Degree in Business, Marketing or other related area, or relevant experience and/or education as determined by the company in lieu of bachelor's degree PREFERRED EDUCATION + Master's Degree - Business Administration, Marketing EXPERIENCE Minimum: - 7 - 10 years' experience with deep breadth and depth of business knowledge in the health and wellness and/or clinical services space Preferred: - Deep healthcare expertise - Clinical programs policy background KNOWLEDGE, SKILLS & ABILITIES - Prior experience executing eminence activities - Strong understanding of market trends/needs, business requirements and balance them successfully - Research and analytics skills - External market orientation - Ability to work in a matrixed organization environment REQUIRED LICENSURE None PREFERRED LICENSURE None TRAVEL REQUIREMENT: 25% - 50% LANGUAGE REQUIREMENT (other than English)? None PHYSICAL, MENTAL DEMANDS AND WORKING CONDITIONS (The physical, mental demands and working conditions described here are representative of those that must be met by an employee to successfully perform the essential function of their job. Reasonable accommodations will be made when necessary to enable individuals with disabilities to perform the essential duties of the position, to the extent that they do not cause undue hardship). Position Type: Office-Based Office-Based Positions An employee in this position works in an office environment. The position frequently requires the employee to communicate effectively with others both inside and outside the workplace (e.g., in person, via telephone, via email). The employee must be able to understand, interpret and analyze data, solve problems, concentrate, and research, use available technological resources and systems (e.g., computers and computer programs), multi-task, prioritize, and meet multiple deadlines to complete essential tasks. The employee generally works in a fast-paced and frequently stressful environment, must attend work on a regular and reliable basis as well as adhere to all workplace policies, and may be called upon to work outside regular business hours. Most On-The-Road Positions An employee in this position may work in a home or company office environment but is also frequently driving to and from various locations to perform the work off-site. The position frequently requires the employee to communicate effectively with others both inside and outside the workplace (e.g., in person, via telephone, via email). The employee must be able to understand, interpret and analyze data, solve problems, concentrate, and research, use available technological resources and systems (e.g., computers and computer programs), multi-task, prioritize, and meet multiple deadlines to complete essential tasks. The employee generally works in a fast-paced and frequently stressful environment, must attend work on a regular and reliable basis as well as adhere to all workplace policies, and may be called upon to work outside regular business hours. Teaches/Trains others regularly Occasionally Travels regularly from the office to various work sites or from site-to-site Occasionally Works primarily out-of-the office selling products/services (Sales employees) Does Not Apply Physical Work Site Required Yes Non-Office-Based Positions An employee in this position is frequently required to move throughout the workplace, sit, stand and walk, use hands and fingers to hold objects, tools or controls, possess fine motor skills (e.g., to write and operate a computer or to steer transportation equipment), possess gross motor skills (e.g., to carry items), reach with hands and arms, climb stairs and ladders, balance, stoop, kneel crouch and crawl, communicate effectively, and talk and hear. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. The employee must be able to work in a busy environment where decisions often must be made quickly, must attend work on a regular and reliable basis, must adhere to all workplace policies, and may be called upon to work outside regular business hours. This work occurs in a [example: warehouse, hospital or provider's office or mailroom]. Lifting: up to 10 pounds Does Not Apply Lifting: 10 to 25 pounds Does Not Apply Lifting: 25 to 50 pounds Does Not Apply ADDITIONAL INFORMATION Changes Approved By: Melanie Lysne Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. **Pay Range Minimum:** $78,900.00 **Pay Range Maximum:** $147,500.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273528
    $78.9k-147.5k yearly 30d ago
  • Senior Artificial Intelligence (AI) Consultant

    Highmark Health 4.5company rating

    Consultant job at Highmark

    This job is responsible for collaborating with leaders to understand their business objectives and challenges and providing expert guidance on the integration of artificial intelligence. This individual conducts assessments of systems, data, infrastructure, and business processes to identify opportunities for AI products and services. The incumbent collaborates across vendor partners, internal data scientists, data, and infrastructure to facilitate requirements gathering for AI product and service proof of concept design and advises on the implementation plan. The AI Consultant serves as an expert in change management, facilitating interventions to prepare for user readiness and adoption and supports business project teams on tactical implementation to ensure optimal value creation. **ESSENTIAL RESPONSIBILITIES** + Problem Identification:Collaborate with business leaders and partners to identify automation opportunities.Create and deliver education to individuals and teams to support effective ideation. Work with data science teams to triage and prioritize ideas in a consistent manner while keeping the business informed along the journey.Serve as a solution designer by recommending roadmaps and/or identifying patterns that could lead to a higher return on investment. + Proof of Concept Design:Work across teams to facilitate the design of a proof of concept.Ensure alignment around the problem statement and the measures that would determine whether the solution is viable.Facilitate engagement across partners and stakeholders to drive timely decision making and business case design. + Implementation:Facilitate the process to translate proof of concept into scaled use and value creation.This includes working with project leads and business owners to create plans that care for all of the technical and people related change impacts in support of the business case.Serve as an advisor and partner for change execution. This includes, but is not limited to, working with internal and external learning and communications partners and change strategists to design and deliver interventions that mitigate adoption risk. + Value Creation:Work with business leaders, portfolio teams, human resources, and finance to take the necessary steps to ensure that the value captured in the business case is captured in the respective systems. + Other duties as assigned or requested. **EXPERIENCE** **Required** + 5 years of experience in management consulting or strategy. + 5 years of experience in orchestrating and leading change management plans and interventions. **Preferred** + 2 years of experience in digital transformation at scale. **SKILLS** + Strong understanding of AI technologies, including generative AI, machine learning, deep learning, natural language processing, and computer vision. + Ability to understand business challenges and identify opportunities for AI implementation. + Strong analytical and problem-solving skills to develop AI solutions that align with business objectives. + Experience working with cross-functional teams, including business stakeholders, IT professionals, and data scientists. + Ability to effectively communicate complex AI concepts to both technical and non-technical audiences. + Strong presentation skills to convey insights and recommendations to stakeholders + Experience in writing technical documentation and reports. + Ability to manage AI projects from inception to deployment, including planning, budgeting, and risk management (technology and people). + Commitment to staying up-to-date with the latest advancements in AI and related technologies. **EDUCATION** **Required** + Bachelor's degree in business, information technology, computer science, data science, or related field (OR) relevant experience and/or education as determined by the company in lieu of bachelor's degree. **Preferred** + Master's degree in business, information technology, computer science or related field. **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + Certified change management practitioner. **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office- or Remote-based Teaches / trains others Occasionally Travel from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required No Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. _ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $108,000.00 **Pay Range Maximum:** $201,800.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J272828
    $108k-201.8k yearly 48d ago
  • EAP Management Consultant - Remote

    Unitedhealth Group Inc. 4.6company rating

    San Francisco, CA jobs

    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 essential functions of the EAP Management Consultant clinical position include providing strategic management consultation and organizational support to all levels of a customer's organizational structure and the clinical case management of employer-based referrals. The Management Consultant acts as an external champion who is recognized as a content expert in the areas of EAP, Behavioral Health, and Work / Life issues, providing consultation to key customer functions including Human Resources, Management/Supervisors, Occupational Health, Safety / Security, Unions and Legal. The Consultant responds to crisis calls and coordinates urgent, emergent care and Fitness for Duty evaluations ensuring public and workplace safety. Work Schedule: Full-Time: 40 HPW Work Location: San Francisco, CA (Remote) The EAP Management Consultant is a strategic partner for client customers around critical workplace issues involving behavioral disturbances, violations of company drug free workplace policies, workplace violence and other risk issues impacting the individual employee, the workplace and/or the community/general public. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Collaborates, consults and coaches client company HR, Occupational Health, and management leadership including senior executives, security and legal at all levels to address organizational, behavioral, and performance concerns, identify options and develop appropriate strategic action plans. Performs behavioral risk screenings for the organization and individual employee for a wide variety of workplace and individual behavioral issues impacting job performance Assures appropriate resources are engaged * Facilitates Federally mandated and regulatory Drug free Workplace and other safety sensitive initiatives such as DOT, NRC, Threats of Violence following pertinent regulatory and best practice guidelines * Conducts in-depth telephonic clinical assessment and referral, assesses members for risk factors when appropriate to ensure member's safety and intervenes appropriately on emergency calls while staying within the scope of EAP/MC services * Provides telephonic solution focused psychoeducation/consultation to management referred employees * Manage cases on referred employees using their clinical skills and judgment to identify underlying clinical issues that may impact on workplace performance, selecting providers with specific expertise to address the identified clinical concerns and / or determine the appropriate level of care * Reviews initial clinical assessment with providers and relays workplace and job performance concerns and expectations involving job performance, mental health, chemical dependency and other behavioral issues * Certifies and authorizes and/or coordinates necessary treatment or EAP services. Discusses treatment plans with provider and negotiates changes as per Level of Care guidelines and EAP best practices * Conduct organizational consultations to managers, supervisors, HRBP, and other organizational leaders to address any workplace concerns * Provides referrals to internal resources such as Work Life, Legal and Financial Services as well as Community Resources as appropriate * Provide backup support across workplace support teams and other EAP teams as needed * Coordinates care with emergency services, CIRS, care management team and other managed health organizations as clinically appropriate * Obtains supervision case consultation from supervisors on a regular basis regarding member care, high risk issues and protocols, policy and procedural changes and updates regarding existing, former, or new client groups * Quotes and explain benefit coverage to members and to providers. Follows appropriate benefit eligibility procedures * Follows internal ethical and regulatory privacy policies such as HIPPA, maintaining confidentiality and private health information of members. Follows state and federal licensing practices. Document necessary case information using same guidelines * Use UHG computer-based case management portals. Creates and maintains appropriate clinical records * Participate in staff meetings, case conferences, and in-service opportunities * Participates as directed in the Quality Assurance Program * Engages in projects and other activities as directed by the Management Consultant Supervisor Manager * Demonstrates a willingness to support and grow both the culture and mission of Optum and the UnitedHealth Group * Works cooperatively with MC team and other UHG departments 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: * Master's degree in counseling, Psychology, Social Work, or related field * Current, unrestricted, independent behavioral health license in the state of residence (LPC, LCSW, LMFT, PsyD / PhD Licensed Psychologist) * 3+ years post masters direct clinical experience in settings such as: EAP, managed care, private or public clinics * 3+ years of experience in mental health, chemical dependency, and workplace issues * Advanced knowledge of behavioral risk factors and have ability to assess a wide variety of workplace behavioral and performance issues * Demonstrated fluency in accessing appropriate referral within or outside the company * Solid interpersonal skills and the ability to work effectively among different levels of management and personnel Preferred Qualifications: * Certified Employee Assistance Professional (CEAP) * Training or work experience in EAP, workplace, and organizational dynamics * Familiarity with regulatory knowledge including Department of Transportation, Nuclear Regulatory Commission and Department of Defense * 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 hourly pay for this role will range from $28.94 to $51.63 per hour 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.
    $28.9-51.6 hourly 3d ago
  • Senior Decision Support Consultant

    Highmark Health 4.5company rating

    Consultant job at Highmark

    This position serves as a critical business-to-technical liaison, bridging the gap between business needs and the analytical technology team. The Senior Decision Support Consultant will leverage technical, analytical, and business expertise to design, develop, and support various complex projects and data analyses. A primary responsibility is to transform loose business language and high-level business needs into precise technical requirements, while also being capable of developing technical solutions. The consultant will act as a senior resource within the team, fostering business-to-technical collaboration and providing strategic consultation directly to department leadership through engagement with business stakeholders. They will advise and consult on Enterprise Informatics strategy, business relationships, the impact of Highmark's business decisions on Informatics, personnel utilization, and the use and planning of technology. The role involves executing all facets of the Informatics project management process, leading multiple project managers, and potentially guiding, mentoring, or providing senior-level oversight to lower-level analysts through all stages of project design and analysis. The incumbent will utilize advanced technical skills, a deep understanding of core business units, their processes, and relevant data flows to prepare and analyze large, complex datasets, ensuring a robust analytical and financial analysis capability for Highmark's pharmacy and medical benefit specialty drug management programs. Furthermore, the incumbent will utilize advanced knowledge of corporate systems and data sources across Highmark's business units, coupled with a general understanding of data flows from various corporate systems (e.g., claims, billing, lab, and Rx), to solve complex issues and problems. A comprehensive understanding of healthcare terminology, techniques, and reimbursement mechanisms, both within the healthcare industry and Highmark, is essential. **ESSENTIAL RESPONSIBILITIES** + Consultation + Provide insight into Enterprise Informatics analyses and provide consultative guidance to Highmark partners . + Key business contact throughout numerous business units that may assist in the resolution of issues or problems. + Access, review, utilize, contribute content to and participate in the maintenance of the shared Enterprise Informatics Intellectual Capital Repository to include but not limited to, review/editing of content submissions and best practices, audit reports, etc. The incumbent is expected to make major contributions to the Repository. + Performs Enterprise Informatics liaison advocacy for emerging areas of Highmark business and leads support liaison advocacy on behalf of selected Highmark business areas. Advocacy involves the representation of the business partner's critical business objectives when prioritizing new work requests vis-à-vis existing workload and resource commitments + Provide overall technical direction (analytic and/or computing) of complex projects to creatively implement effective decision support applications and consultation on the design, testing, and enhancement of reporting systems. Recommends improvement to plan design + Provides feedback to various areas in order to improve service delivery and enhance program design efforts. + Develop and foster relationships across Highmark and with professional organizations, user groups and industry trade groups to stay current with technology and analysis methods. + Modeling & Methodologies + Work independently or leading a multidisciplinary team, designs and implement new analytic models and methodologies of a complex nature for profiling providers, assessing patient outcomes, studying cost and utilization trends and quantitative projections of industry and competitor performance, and conducting other general decision support activities + Lead special complex studies, computer simulations, statistical testing and projects to solve unique problems/questions identified by middle/senior management, business partners, coalitions and governmental agencies. These studies and projects may involve all aspects of the health insurance business and care management processes and may be confidential in nature or for public dissemination. + Performs or leads staff in the development and maintenance of highly complex computer programs using 4GL programming languages and other advanced database/SQL technology, statistical modeling, system testing activities, lead initial problem identification and resolution activities, maintains program/system documentation and prepares/maintains operations documentation for assigned applications. + Utilize or lead the integration of data obtained from external sources such as HC4, HMS, Medco, Acxiom, NCQA, and BCBSA with internal Highmark data. This position routinely utilizes data including, but not limited to: medical/surgical physician and institutional claims and encounters, clinical data, prescription drug data, membership data, dental and vision claims, provider data, financial data (i.e., revenue, premium, billing, pricing) and a variety of external normative and benchmark data. + Lead the evaluation and selection of new complex clinical and technical products and methodologies necessary to enhance current capabilities and positively impact corporate performance + Researches, manipulates, and prepares data related to Health Management programs that document program activities and the results of Health Management interventions and initiatives. + Project Management + Execute all facets of the Informatics project management process and lead multiple project managers. + Independently complete problem definition, requirements gathering, analysis design, statistical testing, results interpretation, and presentation of findings (online, written or verbal). + Independently ensure that the resulting methodologies/processes/software systems are compatible with the corporate technology architecture and is responsible for planning and managing the ISG implementation of the new function/object into the production processing environment. + Identification of parallel issues and project needs in medical and/or business literature + Other duties as assigned or requested. **PREFERRED RESPONSIBILITIES** **QUALIFICATIONS** **Minimum** + Bachelor's Degree or relevant experience and/or education as determined by the company in lieu of bachelor's degree + 10-15 years experience in support of a Marketing function or Data Analyst role or in a business environment with responsibility for application of technology in the solution of business problems. + 10-15 years experience in querying relational databases utilizing 4GL programming languages such as: SAS and SQL. + 10-15 years experience performing project management activities, such as + Problem identification + Meeting project standards and deadlines + Collection of sufficient & accurate information **PREFERRED** + Master's degree in or related to Computer/Information Science, Mathematics/Statistics, Economics, Industrial Engineering or Operations Research **SKILLS** + Demonstrated strong programming skills, with an emphasis on the utilization of SAS and SQL, or comparable 4GL programming language, in querying relational databases. + Demonstrated understanding of relational databases and normalization schema, data source availability, interpretation of field elements, their application and interrelation and file structures and system requirements necessary in accessing information and in investigating and attempting to resolve data anomalies. + Strong knowledge of other Highmark business areas, their processes and data flows as they impact analyses performed by Informatics, including knowledge of file structures, system requirements, processes and functionality. + Demonstrated advanced skills and experience using sophisticated analytic techniques and tools to solve complex problems and reveal insights derived from data analysis not readily apparent through the application of more standard techniques and tools. + Demonstrated ability to concurrently perform multiple complex tasks as directed or as needed, in a manner that maximizes productivity. + Demonstrated strong written and verbal communication skills with an emphasis on management-level consultative customer service, conflict resolution, interpersonal and group/meeting presentations or participation in meetings involving technical, non-technical and customer associates or audiences. + Strong understanding of the terminology, techniques, and reimbursement mechanisms employed in the delivery of healthcare is necessary. **Preferred Skills** + Experience and demonstrated proficiency as a Decision Support Analyst or equivalent training and experience in a business, specialty pharmacy, clinical pharmacy or clinical environment with direct responsibility for applying technology. + Demonstrated experience and proficiency using 4GL programming languages (such as R, Python, SAS, SQL) and other + Database technology (Hadoop, DB2, Teradata, Oracle, Google Cloud). Demonstrated experience in building data products using PowerBI. **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $78,900.00 **Pay Range Maximum:** $147,500.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J271594
    $78.9k-147.5k yearly 59d ago
  • Senior Information Risk Consultant

    Highmark Health 4.5company rating

    Consultant job at Highmark

    **Candidates residing within a 50-mile radius of Highmark offices in Camp Hill, Buffalo, or Pittsburgh will be required to work a hybrid schedule, with in-office attendance on Tuesdays, Wednesdays, and Thursdays at one of these locations. Candidates whose primary residence is outside this 50-mile radius will also follow a hybrid work model.** *****CANDIDATE MUST BE US Citizen (due to contractual/access requirements)***** The Senior Information Risk Consultant serves as the strategic lead for M&A cybersecurity integration, driving governance and assurance across multiple concurrent acquisitions. This role establishes and manages the Cybersecurity Integration Management Office (C‑IMO), ensuring seamless alignment of security requirements during pre- and post-acquisition phases. Beyond M&A, the position provides expert leadership in policy stewardship, control assurance, and information security program maturity, guiding initiatives that strengthen compliance with HIPAA, NIST CSF 2.0, PCI DSS, and SOC frameworks. Acting as a trusted advisor, the analyst interprets complex regulatory and contractual obligations, mentors team members, and partners with cross-functional stakeholders to deliver governance excellence and executive-ready reporting. **ESSENTIAL RESPONSIBILITIES** + Lead in conducting information risk assessments as assigned to the team. Request and analyze documentation necessary to perform appropriate assessment and conduct necessary interviews in order to collect and review relevant materials necessary to produce results of the assessment. + Clearly and concisely document and communicate risk assessment results with requester, security architects and management, as appropriate. + Conduct and formulate appropriate risk scoring, as it relates to threat, vulnerability, likelihood, impact, security controls/countermeasures, etc. + Understand and contribute to inventory of risk register tracking, scoring and associated risk statements. + Perform follow up activities related to exceptions, risk acceptance, corrective action plans and additional mitigation activities. + Communicate risk treatment methodology, risk avoidance, risk acceptance, risk transference and risk mitigation to appropriate groups. + Take lead role in partnering with multiple projects and initiatives to apply security architecture requirements, develop architecture solutions, integrate security into solution designs, access risks of security gaps, and develop architecture remediation. + Take lead role with HM Health Solutions teams in developing and maintaining appropriate procedural documentation which meets relevant compliance standards, such as Payment Card Industry - Data Security Standards (PCI-DSS), Health Information Trust Alliance (HITRUST), and International Organization for Standardization (ISO) 27001. + Prepare and present solution decks to different levels of management and varying technical experience. + Lead in assuring compliance to required standards, procedures, guidelines and processes. + Other duties as assigned or requested. **REQUIRED EDUCATION** Bachelor's Degree - Information Security, Information Systems, Information Assurance, Computer Science or related field **_Substitutions_** At least 10 years' experience in Information Security, Governance, Risk and/or Compliance **PREFERRED EDUCATION** Master's Degree - Computer Science, Information Security or related field **EXPERIENCE** **_Minimum:_** + 7 - 10 years' experience in Information Security and/or Information Risk Management and/or Information Technology + 5 - 7 years' experience within Information Security Governance, Risk and/or Compliance functions and activities + 7 - 10 years' experience developing, communicating and presenting Information Security and Risk Management concepts to varying audiences + Familiarity with technologies such as intrusion Prevention Systems (IPS), firewalls, endpoint protection, web/email filtering, Data Loss Prevention (DLP), digital rights management, encryption, Security Event and Incident Management (SEIM), and virtualization platforms **_Preferred:_** + 10 - 15 years' experience in Information Security and/or Information Risk Management including: + Proven leadership in cybersecurity governance for mergers and acquisitions, including development and execution of integration playbooks and governance frameworks. + Demonstrated ability to drive policy lifecycle management, ensuring timely updates and alignment with HIPAA, NIST CSF 2.0 and other authoritative source requirements. + Experience leading control assurance and maturity improvement initiatives, with a focus on remediating gaps and strengthening the cyber security posture. + Strong background in interpreting and applying security policies, standards, and regulatory requirements within complex business and technical environments. + Expertise in coordinating cross-functional governance forums and producing executive-ready dashboards and narratives for leadership decision-making. + Familiarity with governance tools and platforms such as RSA Archer (GRC), Icertis CLM, and policy management systems. + Ability to mentor team members and contribute to the strategic direction of cybersecurity governance programs. **KNOWLEDGE, SKILLS & ABILITIES** + Knowledge of HITRUST CSF, NIST 800-83 cyber security framework, PCI, HIPAA, HITECH, COBIT, ISO 27001/2, and ITIL 3 + Knowledge of NIST Risk Assessment methodology + Familiarity with secure SDLC best practices + Knowledge of OCTAVE or OCTAVE Allegro risk methodology + Ability to work within high performance, multi-discipline teams + Strong teamwork and inter-personal skills **REQUIRED LICENSURE** None **PREFERRED LICENSURE** Certified Information Systems Security Professional (CISSP), Certified Information Security Manager (CISM), Certified Information Systems Auditor (CISA), SANS or similar industry certifications **TRAVEL REQUIREMENT:** 0% - 25% **LANGUAGE REQUIREMENT (** **_other than English_** **)?** 0% - 25% **PHYSICAL, MENTAL DEMANDS AND WORKING CONDITIONS** ( _The physical, mental demands and working conditions described here are representative of those that must be met by an employee to successfully perform the essential function of their job. Reasonable accommodations will be made when necessary to enable individuals with disabilities to perform the essential duties of the position, to the extent that they do not cause undue hardship._ **_Position Type:_** Office-Based **_Office-Based Positions_** An employee in this position works in an office environment. The position frequently requires the employee to communicate effectively with others both inside and outside the workplace (e.g., in person, via telephone, via email). The employee must be able to understand, interpret and analyze data, solve problems, concentrate, and research, use available technological resources and systems (e.g., computers and computer programs), multi-task, prioritize, and meet multiple deadlines to complete essential tasks. The employee generally works in a fast-paced and frequently stressful environment, must attend work on a regular and reliable basis as well as adhere to all workplace policies, and may be called upon to work outside regular business hours. Teaches/Trains others regularly Frequently Travels regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (Sales employees) Does Not Apply Physical Work Site Required Yes **_Most On-The-Road Positions_** An employee in this position may work in a home or company office environment but is also frequently driving to and from various locations to perform the work off-site. The position frequently requires the employee to communicate effectively with others both inside and outside the workplace (e.g., in person, via telephone, via email). The employee must be able to understand, interpret and analyze data, solve problems, concentrate, and research, use available technological resources and systems (e.g., computers and computer programs), multi-task, prioritize, and meet multiple deadlines to complete essential tasks. The employee generally works in a fast-paced and frequently stressful environment, must attend work on a regular and reliable basis as well as adhere to all workplace policies, and may be called upon to work outside regular business hours. **_Non-Office-Based Positions_** An employee in this position is frequently required to move throughout the workplace, sit, stand and walk, use hands and fingers to hold objects, tools or controls, possess fine motor skills (e.g., to write and operate a computer or to steer transportation equipment), possess gross motor skills (e.g., to carry items), reach with hands and arms, climb stairs and ladders, balance, stoop, kneel crouch and crawl, communicate effectively, and talk and hear. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. The employee must be able to work in a busy environment where decisions often must be made quickly, must attend work on a regular and reliable basis, must adhere to all workplace policies, and may be called upon to work outside regular business hours. This work occurs in a [example: warehouse, hospital or provider's office or mailroom]. Lifting: up to 10 pounds Does Not Apply Lifting: 10 to 25 pounds Does Not Apply Lifting: 25 to 50 pounds Does Not Apply **ADDITIONAL INFORMATION** **Changes Approved By:** Kathleen Thompson **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement:_** _This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies_ As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. **Pay Range Minimum:** $78,900.00 **Pay Range Maximum:** $147,500.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273826
    $78.9k-147.5k yearly 24d ago
  • Advisory Consultant - Payer Strategy - Remote

    Unitedhealth Group 4.6company rating

    Eden Prairie, MN jobs

    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 Advisory Consultant - Payer Strategy - Remote works within a team and serves a key role in contributing to client engagement problem solving and work product development. The Consultant structures and conducts analysis and creates content for assigned workstreams under direction from project lead and contributes to assisting more junior team members with their responsibilities. This role will support client communications around own workstream and at times those of more junior team members and successfully work under timelines for own work along with assisting junior team members with theirs, in accordance with overall project requirements. This role is a major contributor to team problem solving across full scope of each project. The Consultant will participate in various practice development projects, proactively anticipate challenges and risks in both own area and those of junior staff, make sound adjustments/recommendations to address issues, and play an active role in improving business processes, knowledge management, etc. 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. **Primary Responsibilities:** + Structure approach/analysis for assigned workstream under direction and contribute to assisting more junior team members with their responsibilities + Contribute to client communications around own workstream and sometimes those of more junior team members + Major contributor to team problem solving across full scope of project + Knowledgeable on Optum data sets and tools and carries foundational understanding of health care industry dynamics + Maintain a comprehensive understanding of health care research, tools, and assets used by the practice to support client work + Participate in various practice development projects + Provide active role in improving business processes, knowledge management, etc. within the practice + Proactively anticipate challenges and risks in both own area and those of more junior staff and make sound adjustments/recommendations to address issues + Communicates effectively and accurately in writing and verbally to prospects, members and other team members 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:** + 1+ years working in payer strategy, provider network, NCQA/URAC accreditation, provider data management, or value-based care + 1+ years of experience utilizing formal industry strategy frameworks + 1+ years of healthcare, payer (primary) or life sciences experience + Experienced in Quantitative/Qualitative Analytic execution and synthesis + Client relationship management experience + Proficiency in MS Office Suite - Word, PowerPoint, Excel + Demonstrated ability to anticipate challenges and provide solutions + Demonstrated ability to drill down to the root cause of issues and be creative in problem solving + Demonstrated ability to travel domestically, up to 50% **Preferred Qualifications:** + Healthcare, payer and/or provider, life sciences experience + Experience conducting strategy projects + Experience working in and successfully navigating a matrixed environment + Demonstrated ability to possess analytical reasoning and solution-focus problem solving + Demonstrated ability to participate in cross-functional teams + Demonstrated ability to work independently with minimal supervision *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 $71,200 to $127,200 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._
    $71.2k-127.2k yearly 40d ago
  • Advisory Consultant - Payer Strategy - Remote

    Unitedhealth Group Inc. 4.6company rating

    Eden Prairie, MN jobs

    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 Advisory Consultant - Payer Strategy - Remote works within a team and serves a key role in contributing to client engagement problem solving and work product development. The Consultant structures and conducts analysis and creates content for assigned workstreams under direction from project lead and contributes to assisting more junior team members with their responsibilities. This role will support client communications around own workstream and at times those of more junior team members and successfully work under timelines for own work along with assisting junior team members with theirs, in accordance with overall project requirements. This role is a major contributor to team problem solving across full scope of each project. The Consultant will participate in various practice development projects, proactively anticipate challenges and risks in both own area and those of junior staff, make sound adjustments/recommendations to address issues, and play an active role in improving business processes, knowledge management, etc. 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. Primary Responsibilities: * Structure approach/analysis for assigned workstream under direction and contribute to assisting more junior team members with their responsibilities * Contribute to client communications around own workstream and sometimes those of more junior team members * Major contributor to team problem solving across full scope of project * Knowledgeable on Optum data sets and tools and carries foundational understanding of health care industry dynamics * Maintain a comprehensive understanding of health care research, tools, and assets used by the practice to support client work * Participate in various practice development projects * Provide active role in improving business processes, knowledge management, etc. within the practice * Proactively anticipate challenges and risks in both own area and those of more junior staff and make sound adjustments/recommendations to address issues * Communicates effectively and accurately in writing and verbally to prospects, members and other team members 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: * 1+ years working in payer strategy, provider network, NCQA/URAC accreditation, provider data management, or value-based care * 1+ years of experience utilizing formal industry strategy frameworks * 1+ years of healthcare, payer (primary) or life sciences experience * Experienced in Quantitative/Qualitative Analytic execution and synthesis * Client relationship management experience * Proficiency in MS Office Suite - Word, PowerPoint, Excel * Demonstrated ability to anticipate challenges and provide solutions * Demonstrated ability to drill down to the root cause of issues and be creative in problem solving * Demonstrated ability to travel domestically, up to 50% Preferred Qualifications: * Healthcare, payer and/or provider, life sciences experience * Experience conducting strategy projects * Experience working in and successfully navigating a matrixed environment * Demonstrated ability to possess analytical reasoning and solution-focus problem solving * Demonstrated ability to participate in cross-functional teams * Demonstrated ability to work independently with minimal supervision * 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 $71,200 to $127,200 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.
    $71.2k-127.2k yearly 20d ago
  • Advisory Services Sr. Consultant - Epic Healthy Planet

    Unitedhealth Group Inc. 4.6company rating

    Eden Prairie, MN jobs

    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. Optum's EHR Services represents one of the fastest growing practices within Optum Insight's Advisory and Implementations business unit. The EHR Services practice is comprised of 600+ individuals across the U.S. and Ireland who are dedicated to improving the healthcare delivery system through the power of healthcare technology, specifically, the EHR and integrated applications and tools. By joining the EHR Services team, you'll partner with some of the most gifted healthcare technology thought leaders within the industry, collaborate with experienced consulting and healthcare leaders, and help partners capture the benefits of their EHR investment. Optum needs a solid Technical Project Manager with hands-on integration (interfaces and conversions) experience to play a crucial role in ensuring the successful execution of EHR Services implementation projects. You will be pivotal in effectively managing integration project teams working in conjunction with other project leaders for large projects, and in owning and running integration specific projects. Your expertise in project management methodologies and hands-on experience with interface and conversion implementations will be vital in coaching, mentoring, and overseeing the completion of tasks. Solid candidates for this role will be able to demonstrate self-motivation, individual leadership, and team collaboration. Most importantly, our EHR Services team will foster a culture of diversity and inclusion and drive innovation for our company and our clients. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Provide subject matter expertise in Epic Healthy Planet, including system design, build, testing, and implementation * Collaborate with leadership and end users to design and configure solutions, providing technical and clinical consultation, including workflow analysis and application configuration to support enhancements and issue resolution * Lead multiple small to medium-scale Epic upgrade initiatives and workflow enhancements through all project phases * Lead design and validation sessions, ensuring thorough documentation, follow-up, and issue escalation * Maintain system documentation, including design specifications and build records * Monitor production applications and respond to incidents, including participation in 24/7 on-call support as needed * Execute all phases of testing, including unit, system, and integrated testing for EpicCare Ambulatory workflows * Analyze workflows, data collection, reporting needs, and technical issues to support solution development * Collaborate with training teams to develop and maintain application-specific training materials * Translate business requirements into functional specifications; manage system updates, enhancements, and release testing * Ensure compliance with organizational standards for system configuration and change control * Build and maintain solid relationships with end users, stakeholders, and business partners * Facilitate communication across teams from requirements gathering through implementation * Troubleshoot and resolve application issues, escalating complex problems as appropriate * Maintain deep knowledge of Epic functionality and operational workflows 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: * Active Epic certification in Healthy Planet and at least one additional application (i.e., Preferred applications: Ambulatory, Care Everywhere, EpicCare Link or MyChart) * 5+ years of experience in the healthcare industry * 4+ years of experience with Epic implementation and/or support * 3+ years of direct client-facing experience with healthcare domain knowledge such as clinical documentation workflows, patient portals, encounter closure, and patient flow management Preferred Qualifications: * Team management and mentoring experience, both formal and informal * Proven ability to lead cross-functional teams through clear, effective communication and strategic collaboration * Experience in department build and implementation of Community Connect locations * Proficiency with Excel, Visio, PowerPoint and SharePoint * Experience with Refuel implementations Key Competencies: * Time Management & Prioritization: Demonstrates exceptional time management, organizational, and prioritization skills, with a proven ability to manage multiple concurrent responsibilities in fast-paced, dynamic environments * Epic EMR Expertise: Possesses in-depth knowledge of Epic systems, including comprehensive experience across the full implementation life cycle of Epic's suite of applications * Collaborative Leadership: Exhibits a consultative and collaborative leadership style, with a solid track record of aligning cross-functional teams and driving results through shared goals and strategic execution * Relationship Building & Team Motivation: Effectively cultivates and maintains solid internal relationships, inspiring and motivating team members through consultative engagement and influential communication * Strategic Influence & Cross-Functional Collaboration: Demonstrates the ability to build strategic partnerships and influence stakeholders across organizational boundaries. Collaborates across teams, departments, and business units to drive solution standardization, promote reusability, and address complex business challenges * 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 $89,900 to $160,600 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.
    $89.9k-160.6k yearly 20d ago
  • Senior Financial Consultant - Remote

    Unitedhealth Group Inc. 4.6company rating

    Eden Prairie, MN jobs

    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. We are seeking a detail-oriented and strategic Sr Financial Consultant to oversee the development, maintenance, and compliance of our indirect rate structures and estimating system in alignment with Federal Acquisition Regulations (FAR), Cost Accounting Standards (CAS), and Defense Contract Audit Agency (DCAA) requirements. This role is integral to ensuring cost competitiveness, audit readiness, and operational excellence across all government contracting activities. 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. Primary Responsibilities: * Indirect Rates Management * Develop, maintain, and monitor indirect rate structures (fringe, overhead, G&A, service centers, etc.) in compliance with FAR, CAS, and corporate policies * Prepare annual provisional billing rate submissions and analyze incurred cost submissions for government customers * Perform variance analysis between provisional, forecasted, and actual rates; recommend adjustments and corrective actions * Partner with operational and project management teams to assess cost impacts of indirect rate changes * Support audits and negotiations with CMS related to indirect rates * Estimating System Management * Lead the maintenance of the company's estimating system to meet DFARS Business System requirements * Establish policies, procedures, and internal controls for consistent and compliant cost estimating practices * Coordinate cost proposal development with capture, program management, operations, and procurement teams * Provide training to proposal teams on estimating methodologies, cost element development, and documentation standards * Conduct self-assessments and internal reviews to ensure system readiness for government audits * Compliance & Audit Support * Serve as primary liaison with auditors and contracting officers for matters related to indirect rates and estimating processes * Ensure full compliance with FAR Part 15, DFARS, and CAS related to pricing, cost allowability, and allocation * Lead responses to audit findings, corrective action implementation, and policy updates * Strategic Financial Planning * Provide financial modeling and rate impact analysis to support business development and strategic pricing decisions * Support long-range planning and forecasting of indirect cost pools and base structures * Collaborate with leadership to align rate strategies with competitive positioning and profitability goals 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: * Bachelor's degree in Accounting, Finance, or related field * 7+ years of progressive finance/accounting experience in a government contracting environment * Proven experience managing indirect rate structures and government-compliant estimating systems * Deep knowledge of FAR, DFARS, CAS, and DCAA/DCMA audit processes * Solid analytical, problem-solving, and financial modeling skills * Excellent written, verbal, and presentation communication abilities Preferred Qualifications: * CPA, CMA, or CGFM certification * Experience with ERP systems (e.g., Deltek Costpoint) and government cost proposal tools * Prior responsibility for DFARS-compliant estimating or accounting business systems Core Competencies: * Regulatory Expertise - Comprehensive understanding of government cost principles and audit requirements * Detail Orientation - Precision in financial calculations, documentation, and compliance reporting * Collaboration - Ability to partner across functional areas to achieve compliant and competitive cost solutions * Strategic Thinking - Balancing compliance with business growth and pricing competitiveness * Leadership - Guiding teams through complex audits, proposals, and system enhancements * 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 $89,900 to $160,600 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. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
    $89.9k-160.6k yearly 21d ago
  • Senior Financial Consultant - Remote

    Unitedhealth Group Inc. 4.6company rating

    Eden Prairie, MN jobs

    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. We are seeking a detail-oriented and strategic Sr Financial Consultant to support our IT organization. The ideal candidate will have a strong background in financial analysis and forecasting within complex organizational structures and will serve as a trusted partner to IT leadership. The ideal candidate will be a strong collaborator, able to build effective partnerships with IT and other organizational leaders to gain a deep understanding of operational dynamics, enabling them to deliver insightful financial guidance and support. Strong communication skills are essential, as this role will regularly present financial results and actionable insights to senior leaders and decision makers. 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. Primary Responsibilities: * Financial Analysis & Forecasting * Conduct detailed financial analysis to support IT operational and strategic initiatives * Develop and maintain financial forecasts for IT spend across multiple cost pools * Monitor actuals vs. forecast and provide variance analysis with actionable insights * Partner with the Workforce Management team to incorporate workforce modeling inputs into financial forecasts * Analyze workforce data and trends to support accurate and strategic financial planning * Ensure alignment between workforce planning and financial forecasting processes * Business Partnership * Act as a strategic finance partner to IT leadership, helping them manage budgets and optimize spend * Participate in regular reviews with IT stakeholders to align financial performance with business goals * Translate financial data into clear, actionable recommendations for IT decision-makers * Cost Pool Oversight * Provide financial oversight for multiple IT cost pools, ensuring accurate allocation and tracking * Analyze cost distribution across business contract P&Ls and ensure transparency and accountability * Support cost optimization efforts and identify opportunities for efficiency * Reporting & Communication * Prepare and present financial reports, dashboards, and executive summaries tailored to IT leadership * Ensure timely and accurate reporting of IT financials to senior finance and business leaders * Collaborate with accounting and FP&A teams to ensure alignment on financial processes and policies * Process Improvement & Systems * Support automation and enhancement of financial reporting tools and processes * Partner with IT and finance systems teams to improve reporting capabilities 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: * 7+ years of progressive finance/accounting experience, with demonstrated ability to translate financial data into executive-level reporting and insights * Proven advanced analytical and problem-solving skills, with strong proficiency in financial modeling and tools such as Excel and Power BI * Proven to be detail-oriented, with a focus on accuracy, reliability, and efficiency in handling ad hoc requests and recurring deliverables * Proven excellent communication skills, with the ability to convey complex financial findings clearly and concisely to senior leaders and decision makers * Proven solid time management and prioritization skills, with a proven ability to meet tight deadlines in a fast-paced environment * Proven to be self-directed and accountable, able to work independently while managing day-to-day responsibilities effectively * Proven collaborative mindset, with a track record of working across departments and engaging with senior stakeholders * Proven to be a proactive learner, with the ability to quickly grasp complex concepts and adapt to evolving business needs Preferred Qualifications: * Experience with ERP systems such as Deltek Costpoint * Familiarity with Hyperion, Power Query, or similar financial planning tools * Knowledge of FAR, DFARS, and CAS regulations * Basic understanding of IT operations and concepts, enabling effective partnership with IT and Workforce Management teams * 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 $89,900 to $160,600 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.
    $89.9k-160.6k yearly 4d ago
  • Actuarial Sr Consultant - Remote

    Unitedhealth Group 4.6company rating

    Eden Prairie, MN jobs

    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.** In joining the Optum Advisory Services Trend Analytics Consulting team: you'll be part of a team that is a leader in health care cost analytics, with a proven track record of supporting health plans across the country through a diverse staff of Actuaries, Data/Research Analysts, and Business/Technology Consultants. Our consulting team has continued to expand capabilities and consulting presence by identifying, developing, and executing on new and exciting business opportunities. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. MN location preferred. 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. **Primary Responsibilities:** + Performing quantitative analysis of healthcare utilization and cost data, preparing client reports, managing project timelines, and coordinating tasks + Developing and analyzing complex datasets for reporting, clearly communicating analytical implications to stakeholders, and collaborating effectively across teams + As a trusted subject matter expert, the consultant will support ad-hoc analytics, foster strategic client relationships, and take ownership of deliverables in a fast-paced environment + This position is part of a high-performing team focused on continuous improvement and innovation, offering clear direction, recognition, and opportunities to apply traditional expertise to cutting-edge actuarial and analytical solutions + Support in the development of junior analysts 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:** + On the Actuarial exam track, having passed a minimum of 3 or more Actuarial exams + 3+ years hands-on experience in data analysis, data science, data-driven investigations, and/or analytic insight creation for executive consumption + 3+ years of experience handling healthcare claims datasets + 3+ years of experience and an advanced proficiency in SQL, SAS, R, and/or Python, ability to work seamlessly in multiple programming languages + Demonstrated experience using programming to solve complex technical problems + Advanced proficiency in MS Office products: Excel, Word, PowerPoint **Preferred Qualifications:** + Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries designation (FSA) + 2+ years of experience with medical claims/utilization trend reporting + 1+ years of experience with extracting data from Enterprise Data Warehouses and Enterprise Data Lakes + 1+ years of experience working with actuarial team(s) with an understanding of actuarial concepts + Proven analytical, organizational, and problem-solving skills + Proven ability to handle changing priorities/requirements/deadlines + Local to the Eden Prairie, MN office location for 4 days a week in office work arrangement *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 $89,900 to $160,600 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._
    $89.9k-160.6k yearly 60d+ ago
  • Actuarial Sr Consultant - Remote

    Unitedhealth Group Inc. 4.6company rating

    Eden Prairie, MN jobs

    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. In joining the Optum Advisory Services Trend Analytics Consulting team: you'll be part of a team that is a leader in health care cost analytics, with a proven track record of supporting health plans across the country through a diverse staff of Actuaries, Data/Research Analysts, and Business/Technology Consultants. Our consulting team has continued to expand capabilities and consulting presence by identifying, developing, and executing on new and exciting business opportunities. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. MN location preferred. 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. Primary Responsibilities: * Performing quantitative analysis of healthcare utilization and cost data, preparing client reports, managing project timelines, and coordinating tasks * Developing and analyzing complex datasets for reporting, clearly communicating analytical implications to stakeholders, and collaborating effectively across teams * As a trusted subject matter expert, the consultant will support ad-hoc analytics, foster strategic client relationships, and take ownership of deliverables in a fast-paced environment * This position is part of a high-performing team focused on continuous improvement and innovation, offering clear direction, recognition, and opportunities to apply traditional expertise to cutting-edge actuarial and analytical solutions * Support in the development of junior analysts 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: * On the Actuarial exam track, having passed a minimum of 3 or more Actuarial exams * 3+ years hands-on experience in data analysis, data science, data-driven investigations, and/or analytic insight creation for executive consumption * 3+ years of experience handling healthcare claims datasets * 3+ years of experience and an advanced proficiency in SQL, SAS, R, and/or Python, ability to work seamlessly in multiple programming languages * Demonstrated experience using programming to solve complex technical problems * Advanced proficiency in MS Office products: Excel, Word, PowerPoint Preferred Qualifications: * Associate of the Society of Actuaries (ASA) or Fellow of the Society of Actuaries designation (FSA) * 2+ years of experience with medical claims/utilization trend reporting * 1+ years of experience with extracting data from Enterprise Data Warehouses and Enterprise Data Lakes * 1+ years of experience working with actuarial team(s) with an understanding of actuarial concepts * Proven analytical, organizational, and problem-solving skills * Proven ability to handle changing priorities/requirements/deadlines * Local to the Eden Prairie, MN office location for 4 days a week in office work arrangement * 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 $89,900 to $160,600 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.
    $89.9k-160.6k yearly 20d ago
  • Actuarial Senior Consultant - Remote

    Unitedhealth Group Inc. 4.6company rating

    Eden Prairie, MN jobs

    At UnitedHealth Group, we're committed to transforming the health care experience-making it simpler, more affordable, and more equitable for everyone. The work you do here will touch millions of lives and help build a healthier future. Join us in shaping the health care system of tomorrow, where care is connected and communities thrive. Ready to make an impact? Start your journey with us: Caring. Connecting. Growing together. As a Senior Actuarial Consultant within UHG Trend Analytics' - Forecasting & Insights team, you will be instrumental in advancing healthcare analytics and developing data-driven strategies that improve health outcomes. You will collaborate with cross-functional teams to drive innovation, solve complex challenges, and deliver actionable insights for our business partners. Join a dynamic team working on a high-impact initiative focused on Medicare Advantage. In this role, you will help design and build trend forecast models, analyze detailed healthcare claims data, and develop studies that support financial forecasting and strategic planning. You'll apply advanced analytical skills to solve complex business challenges, create partner-ready deliverables, and contribute to improved healthcare outcomes for Medicare beneficiaries. 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. Primary Responsibilities: * Maintain and enhance forecast models for Medicare Advantage financial projections * Support cross-business analytics (Commercial, Medicare, and Medicaid) to ensure consistent modeling * Conduct in-depth data extractions and analyses to provide actionable insights * Identify new opportunities for analytical development in collaboration with stakeholders * Create high-quality written communications, persuasive presentations, and client-ready deliverables * Design analytics and extract data using tools such as R, Python, Excel, SAS, and SQL * Mentor junior team members and lead training sessions to build internal capabilities * Collaborate across departments to deliver holistic solutions to business challenges 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: * Bachelor's degree obtained from an accredited university * Currently on the Actuarial exam track, having passed a minimum of 4 or more Actuarial exams * 4+ years of experience as an actuary in healthcare, finance, or related industry analytics role * 4+ years of experience acquiring, manipulating, and working with large heterogeneous datasets (claim and non-claim based) and using them to solve business problems * Extensive experience in building and maintaining Excel based models * Experience in designing and executing actuarial analyses, including data extraction and analysis using R, Python, SQL, SAS, and/or VBA * Proven ability to create and maintain efficient and scalable models Preferred Qualifications: * Credentialled Actuary (ASA or FSA) * 4+ years of experience working for a healthcare consulting practice * 2+ years of experience collaborating with cross functional partners and presenting analytical findings * 2+ years of experience working in Medicare Advantage * Working on-site in our office located in Eden Prairie, MN * Ability to relocate to Minnesota * 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 $89,900 to $160,600 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.
    $89.9k-160.6k yearly 20d ago
  • Network Pricing Consultant - Remote

    Unitedhealth Group 4.6company rating

    Cypress, CA jobs

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start **Caring. Connecting. Growing together** Can we all can agree that the quality of health care is marching forward and upward with great momentum? Yes. But it's not just quality of care. The entire system is becoming more efficient and effective thanks to companies like UnitedHealth Group and people like you. Here's your opportunity to use your expertise in new ways as you strike the balance between health care costs and resources. Performing unit cost and contract valuation analysis, you'll ensure that healthcare contracts are priced accurately and fairly for all involved. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 5 leader. This position supports and validates Provider Network (physicians, hospitals, pharmacies, ancillary facilities, shared/full risk delegation, etc.) contracting and unit cost management activities through financial modeling, analysis of utilization, and reporting. Conducts unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies. Manages unit cost budgets, target setting, performance reporting, and associated financial models. 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. **Primary Responsibilities:** + Support network pricing strategies and tactics, in collaboration with local network field leaders and network managers + Analyze financial impact of provider contracts (e.g., facility; physician; ancillary) + Analyze financial impact of corporate initiatives (e.g., policy changes; healthcare affordability) or external regulations (e.g., healthcare reform) + Analyze payment appendices to provide options for various contracting approaches and methodologies + Communicate results of financial impact and analysis to appropriate stakeholder groups (e.g., Network Management; Network Pricing leadership) + Conduct financial and network pricing modeling, analysis and reporting + Perform unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies + Lead large, complex projects to achieve key business objectives + Influence pricing strategies and rate development by highlighting opportunities for improvement or protecting favorable rate structures + Strategize rates or contract methodology with network management to create optimal contract + Review competitive analysis to identify appropriate pricing rate for provider 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:** + 4+ years of analytical experience in financial analysis, healthcare pricing, network pricing, healthcare economics or related discipline + 3+ years of experience with provider payment methodologies and healthcare products + 3+ years of experience in creating and using financial modeling tools, spreadsheets and information acquisition tools + Experience with provider capitation, both diagnostic risk-adjustment and age/sex adjusted rate banding + Experience in interpreting and reviewing financial modeling results to evaluate the financial impact of contract changes and develop forecasts + Presentation experience to internal or external stakeholders or customers + Expert level proficiency in MS Excel + Proven expertise in financial impact analysis, risk management and data manipulation + Proven solid interpersonal, collaboration, negotiation and communication skills + Proven excellent communication skills, both written and verbal + Proven ability to manage multiple projects simultaneously and meet deliverable deadlines + Proven ability to research and solve problems independently **Preferred Qualifications:** + Postgraduate degree in Math, Statistics, Finance, Economics or Actuarial Science + Experience in MS Access, SAS, SQL, R, or Python + Experience with advanced statistical functions for financial modeling + Experience with medical coding (CPT, MSDRG, REV, ICD-10, etc.) + Knowledge of Commercial, Medicare, and Medicaid PPO and HMO revenue and expense, as well as delegation financial modeling *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 $71,200 to $127,200 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._
    $71.2k-127.2k yearly 40d ago
  • Network Pricing Consultant - Remote

    Unitedhealth Group Inc. 4.6company rating

    Cypress, CA jobs

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together Can we all can agree that the quality of health care is marching forward and upward with great momentum? Yes. But it's not just quality of care. The entire system is becoming more efficient and effective thanks to companies like UnitedHealth Group and people like you. Here's your opportunity to use your expertise in new ways as you strike the balance between health care costs and resources. Performing unit cost and contract valuation analysis, you'll ensure that healthcare contracts are priced accurately and fairly for all involved. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 5 leader. This position supports and validates Provider Network (physicians, hospitals, pharmacies, ancillary facilities, shared/full risk delegation, etc.) contracting and unit cost management activities through financial modeling, analysis of utilization, and reporting. Conducts unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies. Manages unit cost budgets, target setting, performance reporting, and associated financial models. 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. Primary Responsibilities: * Support network pricing strategies and tactics, in collaboration with local network field leaders and network managers * Analyze financial impact of provider contracts (e.g., facility; physician; ancillary) * Analyze financial impact of corporate initiatives (e.g., policy changes; healthcare affordability) or external regulations (e.g., healthcare reform) * Analyze payment appendices to provide options for various contracting approaches and methodologies * Communicate results of financial impact and analysis to appropriate stakeholder groups (e.g., Network Management; Network Pricing leadership) * Conduct financial and network pricing modeling, analysis and reporting * Perform unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies * Lead large, complex projects to achieve key business objectives * Influence pricing strategies and rate development by highlighting opportunities for improvement or protecting favorable rate structures * Strategize rates or contract methodology with network management to create optimal contract * Review competitive analysis to identify appropriate pricing rate for provider 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: * 4+ years of analytical experience in financial analysis, healthcare pricing, network pricing, healthcare economics or related discipline * 3+ years of experience with provider payment methodologies and healthcare products * 3+ years of experience in creating and using financial modeling tools, spreadsheets and information acquisition tools * Experience with provider capitation, both diagnostic risk-adjustment and age/sex adjusted rate banding * Experience in interpreting and reviewing financial modeling results to evaluate the financial impact of contract changes and develop forecasts * Presentation experience to internal or external stakeholders or customers * Expert level proficiency in MS Excel * Proven expertise in financial impact analysis, risk management and data manipulation * Proven solid interpersonal, collaboration, negotiation and communication skills * Proven excellent communication skills, both written and verbal * Proven ability to manage multiple projects simultaneously and meet deliverable deadlines * Proven ability to research and solve problems independently Preferred Qualifications: * Postgraduate degree in Math, Statistics, Finance, Economics or Actuarial Science * Experience in MS Access, SAS, SQL, R, or Python * Experience with advanced statistical functions for financial modeling * Experience with medical coding (CPT, MSDRG, REV, ICD-10, etc.) * Knowledge of Commercial, Medicare, and Medicaid PPO and HMO revenue and expense, as well as delegation financial modeling * 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 $71,200 to $127,200 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.
    $71.2k-127.2k yearly 20d ago
  • Advisory Sr. Consultant, Cloud Data Engineer - Remote

    Unitedhealth Group 4.6company rating

    Eden Prairie, MN jobs

    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.** We are seeking a highly skilled and experienced Senior Cloud Data Engineer to join our team for a Cloud Data Modernization project. The successful candidate will be responsible for migrating our on-premises Enterprise Data Warehouse to a modern cloud-based data platform utilizing Azure Cloud data tools and Snowflake. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Lead the migration of the ETLs from on-premises database platform-based data warehouse to Azure Cloud and Snowflake + Design, develop, and implement data platform solutions using Azure Data Factory (ADF), Self-hosted Integration Runtime (SHIR), Logic Apps, Azure Data Lake Storage Gen2 (ADLS Gen2), Blob Storage, and Snowflake + Review and analyze existing on-premises ETL processes developed in SSIS and T-SQL + Implement DevOps practices and CI/CD pipelines using GitActions + Collaborate with cross-functional teams to ensure seamless integration and data flow + Optimize and troubleshoot data pipelines and workflows + Ensure data security and compliance with industry standards 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:** + 5+ years of experience as a Cloud Data Engineer + 3+ years of hands-on experience with Azure Cloud data tools (ADF, SHIR, LogicApps, ADLS Gen2, Blob Storage) and Snowflake + 3+ years of experience in ETL development using on-premises databases and ETL technologies + 3+ years of experience with Python or other scripting languages for data processing + 2+ years of experience with development in Databricks for data engineering and analytics workloads + Proficiency in DevOps and CI/CD practices using GitActions + Experience with Agile methodologies + Proven excellent problem-solving skills and ability to work independently + Proven solid communication and collaboration skills + Proven solid analytical skills and attention to detail + Ability to adapt to new technologies and learn quickly + Ability to travel up to 10% **Preferred Qualifications:** + Certification in Azure or Snowflake + Experience with data modeling and database design + Proven knowledge of data governance and data quality best practices + Familiarity with other cloud platforms (e.g., AWS, Google Cloud) *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. The salary range for this role is $89,800 to $176,700 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. 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._
    $89.8k-176.7k yearly 60d+ ago
  • Advisory Sr. Consultant, Cloud Data Engineer - Remote

    Unitedhealth Group Inc. 4.6company rating

    Eden Prairie, MN jobs

    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. We are seeking a highly skilled and experienced Senior Cloud Data Engineer to join our team for a Cloud Data Modernization project. The successful candidate will be responsible for migrating our on-premises Enterprise Data Warehouse to a modern cloud-based data platform utilizing Azure Cloud data tools and Snowflake. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Lead the migration of the ETLs from on-premises database platform-based data warehouse to Azure Cloud and Snowflake * Design, develop, and implement data platform solutions using Azure Data Factory (ADF), Self-hosted Integration Runtime (SHIR), Logic Apps, Azure Data Lake Storage Gen2 (ADLS Gen2), Blob Storage, and Snowflake * Review and analyze existing on-premises ETL processes developed in SSIS and T-SQL * Implement DevOps practices and CI/CD pipelines using GitActions * Collaborate with cross-functional teams to ensure seamless integration and data flow * Optimize and troubleshoot data pipelines and workflows * Ensure data security and compliance with industry standards 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: * 5+ years of experience as a Cloud Data Engineer * 3+ years of hands-on experience with Azure Cloud data tools (ADF, SHIR, LogicApps, ADLS Gen2, Blob Storage) and Snowflake * 3+ years of experience in ETL development using on-premises databases and ETL technologies * 3+ years of experience with Python or other scripting languages for data processing * 2+ years of experience with development in Databricks for data engineering and analytics workloads * Proficiency in DevOps and CI/CD practices using GitActions * Experience with Agile methodologies * Proven excellent problem-solving skills and ability to work independently * Proven solid communication and collaboration skills * Proven solid analytical skills and attention to detail * Ability to adapt to new technologies and learn quickly * Ability to travel up to 10% Preferred Qualifications: * Certification in Azure or Snowflake * Experience with data modeling and database design * Proven knowledge of data governance and data quality best practices * Familiarity with other cloud platforms (e.g., AWS, Google Cloud) * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. The salary range for this role is $89,800 to $176,700 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. 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.
    $89.8k-176.7k yearly 20d ago

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