Payment Integrity Ideation Associate Director Outpatient Facility Coder – Remote

Optum

3+ years

$106,800 to $194,200

Minneapolis and St. Paul, Minnesota.

10 April 16, 2025

Job Description

Job Type: Full Time Education: B.Sc./M.Sc./B.Pharm/M.Pharm/Life science Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

Job Title: Payment Integrity Ideation Associate Director Outpatient Facility Coder – Remote
Location: Minnetonka, MN, US (Remote considered)
Job Category: Healthcare Economics
Requisition Number: 2273553

Company Overview:

Optum is a global leader in delivering healthcare solutions, utilizing technology to improve health outcomes and provide better access to care, pharmacy benefits, and other vital resources. We are committed to improving global health equity and advancing healthcare in communities. Join us in creating a positive impact on health outcomes as part of a diverse and inclusive culture.

What We Offer:

Competitive Salary with incentive programs
Comprehensive Benefits Package (health, dental, vision insurance)
Flexible Work Schedules
Career Development Opportunities
Remote Work Option (must adhere to UnitedHealth Group’s Telecommuter Policy)

Key Responsibilities:

Cost Savings Initiatives:
- Develop a portfolio of initiatives that provide measurable cost savings for clients.
- Provide regular client updates on progress and results of initiatives.
Concept Development & Research:
- Perform investigative and analytical work to support development of new ideas and concepts.
- Lead payment integrity initiatives from inception through to execution, influencing senior leadership.
Internal Collaboration & Influence:
- Build strong relationships with internal stakeholders to define and deliver payment integrity initiatives.
- Recommend changes to product development procedures based on market research and new trends.
Subject Matter Expertise:
- Serve as an industry thought leader on medical claims, trends, pricing, and cost management.
- Lead efforts to improve and innovate clinical and operational processes.

Required Qualifications:

Certifications:
- COC, CCS, ROCC, RHIA, or RHIT with a minimum of 3 years post-certification experience.
Experience:
- 4+ years of experience in outpatient reimbursement and coding.
- 4+ years of experience in auditing, billing, and/or coding claims within a Payment Integrity domain.
- 4+ years of experience working in healthcare (Medicare, Medicaid, Commercial), with focus on Payment Integrity or Revenue Integrity.
- 3+ years of post-certification experience in Outpatient Specialty Surgeries and Procedures.
- 3+ years of experience in collaborative, consultative roles with cross-functional teams.
- 2+ years of experience in claims data research, analysis, and trend identification.
Knowledge:
- Expertise in CMS rules, regulations, billing codes, and services related to claims.

Preferred Qualifications:

Education:
- Advanced degree in healthcare or medical field.
Experience:
- 3+ years of experience in claims adjudication or revenue cycle management.
- 2+ years in a fast-paced, adaptive, deadline-driven environment.
Technical Skills:
- Proficiency in Excel (Pivot Tables, Advanced Formulas, Macros), Visio, PowerPoint, Tableau.

Compensation:

Salary Range: $106,800 to $194,200 annually, based on factors like experience, education, certifications, and local labor markets.

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Payment Integrity Ideation Associate Director Outpatient Facility Coder – Remote

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