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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start **Caring. Connecting. Growing together.** As a Long-Term Support Services (LTSS) Algorithm Manager, this leadership position is responsible for the identification, development, and presentation of new medical cost savings algorithms on behalf of our clients. This position will assess new analytic opportunities based on data insights by leveraging tools, regulations, industry trends and claims analysis. This highly trained industry expert will work with internal and external business constituents to determine opportunities for savings to meet target goals. In addition, the candidate will collaborate with cross-matrix teams, leadership, compliance, legal, and other Program Integrity stakeholders to support meeting client contractual obligations. You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Serves as primary point of contact for client regarding Algo workstream + Identify analytic savings initiatives that drive specific and measurable results, building Algo concept pipeline and providing timely and meaningful client updates + Participate in analytical, investigative work in support of post-pay algorithm development + Algo Lead providing oversight and direction for Algo workstream staff + Serves as a leader/ mentor to staff supporting algorithm workstream + Coordinate assignments and review work performed by others + Establish solid relationships with internal and external stakeholders to define, align, and deliver program integrity initiatives in support of assigned clients + Present data findings with rerun algos and new algo ideas during internal and external meetings + Recommend changes to current product development procedures based on market research and new trends to support algorithm ideation + Propose new claims edit opportunities to client based on analytic trends 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 analyzing claims data in support of analytic/algorithm development + 3+ years of experience developing analytics specifically for detecting FWA, utilizing analytics solutions using data warehousing tools such as SQL/Oracle and writing data criteria requirements + Advanced working knowledge of Microsoft Office (Excel, PowerPoint) and use of Pivot tables + Solid knowledge of federal health care requirements for proper claims billing and a firm understanding of medical terms and procedural coding (CPT, ICD, HCPCS, DRGs) + Proven to be a self-starter with the ability to support multiple projects and meet delivery timelines + Proven to be highly collaborative communication skills with ability to make presentations and establish credibility quickly with leadership across multiple functional areas **Preferred** **Qualifications** **:** + Advanced degree in health care or data science + Coding certification through AAPC or AHIMA + 3+ years Program Integrity experience + 2+ years of experience developing Medicaid/Medicare data analytics + 2+ years of Supervisory/Manager experience + Federal/State regulatory health care compliance experience + Long Term Support Services (LTSS) claims data and audit experience + Advanced level proficiency with SQL and writing data logic criteria + Expert with statistical methods used in the evaluation of healthcare claims data *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._ _Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._