Advisory Services Sr. Consultant - Remote - Remote Eligible

Advisory Services Senior Consultant

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 Services Senior Consultant provides deep expertise in HEDIS data, analytics, and quality measures, assisting organizations in ensuring compliance and improving performance for various health plans. Responsibilities typically include data analysis, HEDIS data validation, NCQA and state specific submissions, user acceptance testing, and developing reports. This role requires solid analytical skills, knowledge of healthcare systems, coding (ICD, CPT) and experience with tools like SQL, PowerBI, and Excel.

You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Analyze, review, and trend complex healthcare data
• Support short and long term operational/strategic business activities through analysis
• Develop recommended business solutions through research and analysis of data and business process and implement when appropriate
• Self-starter that demonstrates accountability for all assignments
• Assess and interpret customer needs and requirements
• Identify solutions to non-standard requests and problems
• Solve moderately complex problems and/or conduct moderately complex analyses
• Work with minimal guidance; seek guidance on only the most complex tasks
• Translate concepts into practice
• Provide explanations and information to others on difficult issues
• Coach, provide feedback, and guide others
• Act as a resource for others with less experience
• Technical skill is required as this position is a mix of business and technical skills

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:

• 3+ years of experience with healthcare claims analysis
• 3+ years of experience; skilled in reading and writing moderate to complex SQL commands and accurately assessing results
• Experience with analyzing HEDIS metrics or working as a Functional SME for HEDIS reporting
• Ability to write clearly composed documentation for business requirements, as well as information that will be distributed to auditors
• Ability to solve problems, including multiple priorities and researching conflicting and/or inaccurate data
• Ability to travel up to 40% of the time (Typically out on Sunday/Monday with return home on Thursday - or shorter trips - as business needs dictate)

Preferred Qualifications:

• Experience with HEDIS vendor software a plus or experience with HEDIS reporting using other tools
• SSIS ETL development experience
• Experience gathering requirements from the client/business and documenting
• Experience with process improvement, workflow, benchmarking, and/or evaluation of business processes
• Intermediate level of proficiency with PC-based software programs and automated database management systems (Excel, Access, PowerPoint)
• Project Management experience
• Working knowledge of relational databases, database structures

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). 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.