Employment Spot

Job Description

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health. Ingenix is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
 
If you get excited about the life transforming potential of bringing health care information to the right place, at the right time, to support crucial decisions, welcome to Ingenix.
 
We're one of the largest and fastest growing health information companies and the only organization in our industry with the information, technology and consulting expertise to solve the most significant challenges in health and human services.
 
In providing consumer-oriented health benefit plans to millions of people, our goal is to create higher quality care, lower costs and greater access to health care. Join us and you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system.
 
Ingenix Payment and Government Solutions has recently consolidated all of it operations centered around avoiding, identifying, and recovering mispaid claims into one business group.  Typically, these functions are individually referred to as Claim Data Mining, Credit Balance Recovery, Claims Editing,  Subrogation, Fraud and Abuse, Hospital Bill, Audit and Recovery and finally, Coordination of Benefits.  Together, we are calling them Payment Cycle Management and they are critical to the continuing administrative simplification of health care and the success of our many Payer clients.  Today, these operations eliminate billions of dollars of waste in the Healthcare system, making Healthcare more affordable.  These functions rely heavily on research analytics to develop new and innovative approaches for identifying and capturing mispaid claims.   Toward this end, we are seeking a leader for the analytics teams across our Payment Cycle Management business.
 
The Vice President will oversee the Payment Cycle Management domain, directing the Research, Analysis, and Innovation functions. He or she will oversee a team of research analysts responsible for developing new methods of avoiding, identifying, and correcting claim overpayments.  This team will be responsible for ideation, research, hypothesis testing, business case development, and prototyping.  Specifically, he or she will be responsible for:  

• Overseeing a team of professional analysts, including Staticians, Epidemiologists, SAS Programmers, and the like.
• Developing and testing new methodologies and  approaches
• Partnering effectively with business leadership and Finance to demonstrate the effectiveness and impact of programs and approaches developed.
• Managing the balance of working with creative, innovative, and analytical constituents with the need for delivering real world solutions.
• Planning and coordinate internal and external ideation and program development meetings.
• Communicating study progress, findings and analyses in written, oral and graphic form to managerial staff, clinical staff and to scientific advisory boards and participating customer/employer groups. 

Job Requirements

• Minimum 10 years in a analytics related role with strong preference to those in a managed healthcare setting.
• Ph.D. or Masters in Epidemiology, Statistics, Healthcare Economics, Health Services Research or other relevant academic fields is required.
• Superior data analysis skills and knowledge of risk adjustment, grouping methodologies, and statistical analysis will be critical to success
• Excellent verbal and written communication skills; strong organizational abilities.
• Demonstrated innovation/research management skills
• Experience with oversight of database construction, governance, and maintenance is preferred.
• A strong understanding of clinical management activities of a large managed healthcare organization is highly desirable
• Ability to multitask and work independently in a fast-paced, highly matrixed environment is critical
• Prior management of analytical resources is required.
• Knowledge of SQL, SAS, and the use of OLAP tools working with DB2, SQL Server, Oracle, and/or other relational databases