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Caring. Connecting. Growing together.We are seeking a highly analytical and results-driven professional to support healthcare claims analytics, pricing accuracy, and operational performance initiatives. This role is responsible for leveraging large-scale healthcare claims data to generate actionable insights, improve claim estimation accuracy, validate business processes, and support enterprise claims adjudication and pricing strategies. The ideal candidate combines solid analytical and technical expertise with a deep understanding of healthcare claims data, enabling effective collaboration across business, operations, product, and technology teams.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities: Data Analytics & Insights:- Analyze large-scale healthcare claims datasets to identify trends, patterns, anomalies, and opportunities for improving cost accuracy, benefit validation, and operational efficiency
- Conduct deep-dive analyses of claim performance metrics, including cost estimate accuracy, denial drivers, benefit validation outcomes, and claim adjudication results
- Translate complex analytical findings into clear, actionable recommendations that support business decision-making and operational improvements
- Develop analytical frameworks and performance measurement methodologies to evaluate claim outcomes and drive continuous process optimization
Data Engineering & Model Development:- Develop, enhance, and maintain data pipelines, datasets, and analytical models that support claims processing, pricing, and estimation workflows
- Partner with engineering and data teams to ensure data quality, consistency, and reliable integration across enterprise data sources and platforms
- Support the design and implementation of scalable analytical solutions that enable efficient reporting, monitoring, and decision support
Claims Validation & Testing:- Leverage data from enterprise claims platforms, including CSP Facets and related adjudication systems, to validate business logic, investigate data discrepancies, and ensure alignment between estimated and actual claim outcomes
- Design and execute analytical testing strategies for trial claims, MBO validation runs, and large-scale claims testing initiatives
- Measure and compare performance across claim adjudication engines, identifying root causes of variance and recommending corrective actions
- Support defect identification, root cause analysis, and validation efforts throughout the claims lifecycle
Cross-Functional Collaboration:- Collaborate with product, operations, business, and technology stakeholders to support strategic initiatives related to claim estimation, adjudication, pricing accuracy, and operational excellence
- Partner with subject matter experts to define requirements, validate methodologies, and ensure business objectives are accurately translated into analytical solutions
- Serve as a trusted advisor by providing data-driven insights and recommendations to support program planning and decision-making
Reporting & Visualization:- Build and maintain dashboards, reports, scorecards, and visualizations that communicate performance metrics and key insights to stakeholders and leadership
- Present findings and recommendations to both technical and non-technical audiences, ensuring clear understanding of business impacts and opportunities
- Monitor key performance indicators and proactively identify emerging trends or potential risks
Continuous Improvement & Automation:- Identify opportunities to automate recurring analytical processes and improve operational efficiency
- Support continuous improvement initiatives through process optimization, advanced analytics, and data-driven recommendations
- Contribute to the development of scalable analytical tools, testing frameworks, and reusable reporting assets
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: - 5+ years of experience in healthcare analytics, claims analytics, data science, or a related analytical role
- Solid knowledge of healthcare claims processing, claim adjudication, pricing methodologies, and benefit structures
- Experience working with healthcare claims platforms such as Facets, CSP, or other enterprise claims adjudication systems
- Advanced SQL and data analysis skills, including experience with large datasets and cloud-based analytics platforms (Databricks, Snowflake, Azure, etc.)
- Proficiency in data visualization and reporting tools such as Power BI, Tableau, or similar platforms
- Experience presenting analytical findings to both technical teams and executive stakeholders
- Solid problem-solving, analytical thinking, and communication skills
*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 $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.
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.
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.
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