Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start
Caring. Connecting. Growing together. As a Payment Integrity Data Analyst, you will be responsible for building and documenting targeted algorithms, conducting analyses of health care membership and cost data, and assuring data quality. As a PI DA you will partner with stakeholders to understand data requirements and develop algorithms for inventory creation, dashboards, data visualizations, decision aids, and business case analysis to support the business and underlying client agreements. Documentation includes creating specifications for product or process builds, creating business requirements or process flows, interpreting results, developing actionable insights, and presenting recommendations for business use. Team members use business intelligence, data visualization, query, and analytic software to build solutions, perform analysis, and interpret data. PI DAs contribute their subject matter expertise in the design of analytics and algorithms.
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: - Research and identify areas for non-clinical medical cost improvements and alternative pricing strategies with government and commercial healthcare payers
- Interpret and analyze claims and membership data
- Write complex SQL queries to execute against large healthcare payer data sets
- Create and update automated database processes
- Analyze reporting utilized by internal customer groups
- Use logical, detail-oriented thought process to break down complex problems into individual sequential steps and identify root causes
- Identify and refine criteria to successfully increase efficiency of algorithm logic
- Contribute to analytic opportunities that may include proof of concept, functional testing, determination of yield, time to complete, and financial impact
- Explore potential trends identified by matrix business partners
- Use business requirements for process automation, analytic development, strategic reporting, and system navigation.
- Execute standalone production processes
- Triage anomalies observed with production processes
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: - 2+ years of experience in a corporate setting
- 2+ years of experience performing data analytics, including identifying trends in large data sets
- 2+ years of experience reading and writing complex SQL statements/queries
- 2+ years of experience with MS Excel, including pivot tables, formulas, calculations, charts, graphs, etc.
- 2+ years of experience working from business requirements documents
Preferred Qualifications: - Experience in COB (Coordination of Benefits) auditing
- Experience in Medicare reimbursement methodology
- Knowledge of NAIC (National Association of Insurance Commissioners) guidelines
*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 $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
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.
