Data Analyst - Payment Integrity - Remote
About The Position
Optum Insight is seeking a Payment Integrity Data Analyst to build and document targeted algorithms, analyze healthcare membership and cost data, and ensure data quality. The analyst partners with stakeholders to understand data requirements and develops algorithms for inventory creation, dashboards, visualizations, decision aids, and business case analysis that support the business and client agreements. The role also involves documenting product and process specifications, business requirements and process flows; interpreting results; developing actionable insights; and presenting recommendations. Team members use business intelligence, data visualization, query, and analytics software to build solutions and conduct analysis. The analyst contributes subject matter expertise to the design of analytics and algorithms. The position is remote within the United States. Employees hired in the Minneapolis or Washington, D.C. area must work in the office at least four days per week. Remote employees must follow UnitedHealth Group’s Telecommuter Policy.
Requirements
- At least 2 years of experience in a corporate setting.
- At least 2 years of experience performing data analytics, including identifying trends in large datasets.
- At least 2 years of experience reading and writing complex SQL statements and queries.
- At least 2 years of experience with MS Excel, including pivot tables, formulas, calculations, charts, and graphs.
- At least 2 years of experience working from business requirements documents.
Nice To Haves
- Experience in Coordination of Benefits (COB) auditing.
- Experience in Medicare reimbursement methodology.
- Knowledge of National Association of Insurance Commissioners (NAIC) guidelines.
Responsibilities
- Research and identify areas for non-clinical medical cost improvement and alternative pricing strategies with government and commercial healthcare payers.
- Interpret and analyze claims and membership data.
- Write complex SQL queries to run against large healthcare payer datasets.
- Create and update automated database processes.
- Analyze reporting used by internal customer groups.
- Break complex problems into sequential steps and identify root causes using logical, detail-oriented reasoning.
- Identify and refine criteria to improve the efficiency of algorithm logic.
- Contribute to analytic opportunities, including proof of concept, functional testing, yield determination, time estimates, and financial impact assessment.
- 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 in production processes.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs.
- Equity stock purchase.
- 401(k) contribution.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
