Optum Claims Editing Jobs (NOW HIRING)

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 Associate Director - Healthcare Economics is a people leader responsible for managing a team of two analysts while serving as a hands-on subject matter expert in payer contracting analytics and renewal strategy development. This player-coach role is critical to supporting the Optum West Payer Contract Analytics team, which provides analytical insights essential for contract negotiations, renewals, competitive intelligence, and financial forecasting.

The position partners closely with healthcare economics, payer contracting, and data informatics teams to evaluate market trends, model financial outcomes, and develop data-driven strategies that optimize payer agreements. As Optum West continues its integration into the National Healthcare Economics (HCE) Data Ecosystem, this leader plays an increasingly important role in leveraging market-specific legacy, proprietary, and public healthcare data to generate actionable insights, enhance analytical capabilities, and inform strategic decision-making. Success in this role requires a blend of solid people leadership, advanced healthcare analytics expertise, business acumen, and the ability to translate complex data into meaningful contract and network strategies.

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:

• Manage the evaluation of payer proposals related to FFS, capitation arrangements and value-based contracts
• Partner with the regional payer contracting teams to manage the modeling and negotiation process, evaluate proposals, and provide guidance to senior leadership on the financial impact and viability of the contract
• Work closely with the Finance and Actuarial teams to translate contract changes/analytics to the financial forecast
• Develop the capabilities and infrastructure necessary to support the growth of the analytics team, contracting entities supported, and advanced analytics
• Design and implement sound tools and applications to efficiently measure, monitor and forecast payer financial performance
• Be a subject matter expert on employer-sponsored, health insurance exchange (HIX) and government sponsored health insurance products funding changes, impact to payer contracts, and the overall managed healthcare landscape
• Contributes to building the next generation of analytic professionals and contributes to enterprise-level goals for talent development, diversity, and inclusion
• Demonstrates continuous learning and maintains a highly skilled and engaged workforce by aligning resource plans with business objectives and ensuring performance management guidelines and expectations drive business objectives and results

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
• 5 years of experience in managed healthcare finance or analytics
• 5 years of experience with payer contracting and value-based compensation programs along the risk continuum with a foundation of reimbursement methodologies, performance improvement and contracting support
• 3 years of experience leading teams
• 3 years of experience in evaluation and use of varying sources of data including data practice management data, other revenue cycle data (claims, encounters), and capitation plan files
• Advanced proficiency working with modeling, query, business intelligence and statistical tools, including Excel, Power BI, MS-SQL/Snowflake (writing, running, and editing queries)

Preferred Qualifications:

• ASA or FSA Actuarial Credential
• Medicare Advantage Bid Pricing Tool experience, or familiarity with Medicare Advantage funding and pricing
• Intellectual curiosity - Proven ability and willingness to learn new actuarial concepts
• Demonstrated ability to influence, motivate, and correct others in a positive, constructive, and respectful way

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $112,700 - $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

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.