Data Analyst - Claims - Remote

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.

Positions in this function are responsible for the management and manipulation of mostly structured data, with a focus on building business intelligence tools, conducting analysis to distinguish patterns and recognize trends, performing normalization operations and assuring data quality. Depending on the specific role and business line, example responsibilities in this function could include creating specifications to bring data into a common structure, creating product specifications and models, developing data solutions to support analyses, performing analysis, interpreting results, developing actionable insights and presenting recommendations for use across the company.

Roles in this function could partner with stakeholders to understand data requirements and develop tools and models such as segmentation, dashboards, data visualizations, decision aids and business case analysis to support the organization. Other roles involved could include producing and managing the delivery of activity and value analytics to external stakeholders and clients. Team members will typically use business intelligence, data visualization, query, analytic and statistical software to build solutions, perform analysis and interpret data. Positions in this function work on predominately descriptive and regression-based analytics and tend to leverage subject matter expert views in the design of their analytics and algorithms. This function is not intended for employees performing the following work: production of standard or self-service operational reporting, casual inference led (healthcare analytics) or data pattern recognition (data science) analysis; and/or image or unstructured data analysis using sophisticated theoretical frameworks. Generally work is self-directed and not prescribed.

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

Primary Responsibilities:

• Report/Business Analysis
  
  
  
  
  • Communicates with the business/customer to understand business objectives and needs
  • Identifies solutions to non-standard requests and problems
  • Solves moderately complex problems and/or conducts moderately complex analyses
  • Translates concepts into practice
  • Is aware of and understands the dependencies and alignment areas that are required between the business needs and other key areas such as data processing, technical design and development, report production, training, and documentation
  • Evaluate network adequacy and accessibility, development opportunities, and network growth to support UHN Network Management strategies and objectives
  
  
  
  
• Data Analysis:
  
  
  
  
  • Demonstrates an understanding of data modeling (relationships, data types, tables, etc.) and analytics concepts (queries, reporting, association of data sources)
  • Interprets requirements and translates them into data requirements (interfaces, data transformation, etc.) for complex projects
  • Designs and/or develops specific databases for collection, tracking, and reporting to facilitate analysis
  • Identify data validation risks and solutions/strategies
  
  
  
  
• Communication Skills:
  
  
  
  
  • Adept at verbal presentation at the manager/director level
  • Explains difficult concepts comfortably at the manager/director level
  • Creates deliverable templates and prepares written materials
  • Expresses independent view constructively, even when others disagree
  • Communicates effectively with clients and team members
  
  
  
  
• Creates work products using standard software packages (Visio, Word, Access, Excel)
• Works with less structured, more complex issues
• Serves as a resource to others
• Creating SQL queries for the auditors Investigate, recover, and resolve all types of claims as well as recovery and resolution for health plans and government entities queries relating to all LOBS
• Ensuring adherence to state and federal compliance policies, reimbursement policies, and contract compliance
• Working with matrix partners to build out the blue chip, wave and big bet projects
• Create reporting based on health plan needs to drive down SLA's
• Automation implementation to make sure it means company and health plan standards
• Maintain and Support volumetric forecasting of inventory around LOB's to ensure right sizing of organization

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 with analyzing large data sources
• 2+ years of experience gathering business requirements
• 1+ years of experience in writing/developing SQL queries
• 1+ years of experience with snowflake
• Knowledge of Python
• Knowledge of C#
• Proficiency with MS Excel (intermediate+)

Preferred Qualifications:

• Experience with SSIS
• Experience with R Studio
• Experience with Tableau or Power BI
• Healthcare knowledge, ideally in claims

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

The salary range for this role is $71,600 to $140,600 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.