Data Analyst - Payment Integrity - Remote

UnitedHealth Group•Brentwood, TN

22h•$72,800 - $130,000•Remote

About The Position

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.

Requirements

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

Nice To Haves

Experience in COB (Coordination of Benefits) auditing
Experience in Medicare reimbursement methodology
Knowledge of NAIC (National Association of Insurance Commissioners) guidelines

Responsibilities

Research and identify areas for potential non-clinical medical cost improvements and alternative pricing strategies with government and commercial 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 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