FWA Senior Data Analyst - Remote

UnitedHealth Group•Eden Prairie, MN

4d•Remote

About The Position

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Fraud, Waste, and Abuse (FWA) Analyst plays a critical role in safeguarding state Medicaid programs by identifying, analyzing, and preventing fraudulent activities within Medicaid claims. You will be working with a State Government Product and Data Mining team. Your primary responsibility will be to assist in the development and deployment of algorithms designed to support program integrity across various platforms and states plus support our fraud and abuse detection product and services. 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. 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.

Requirements

5+ years of fraud, waste and abuse data mining experience
5+ years of experience writing advanced SQL queries
4+ years of data analysis experience working with database structures
4+ years of healthcare claims experience
Proficiency with excel & visualization tools
Proven intermediate to advanced computer skills consisting of Teams, Microsoft Excel, Outlook, Word, and Power Point.
Demonstrated proficiency in research, interpreting, and analyzing diverse and complex data, and assessing data quality
Ability to travel 10%

Nice To Haves

Industry certifications: Certified Professional Coder (CPC) or Certified Fraud Examiner (CFE)
Experience with statistical analysis of data
Knowledge of Medicaid policy and real-life fraud, waste, abuse schemes
Knowledge of healthcare claim adjudication systems
Experience with Rally

Responsibilities

Write simple to complex SQL statements to extract data for client inquiry and research
Utilize production reports to perform research and assess quality of overall data
Analyze and interpret data to identify FWA trends and patterns within claims data.
Applies creative and analytical thinking to uncover and resolve complex fraud, waste, and abuse patterns
Engage with clients to triage and manage incoming operational inquiries and tasks
Identifies innovative approaches to resolve non-standard problems and deliver effective outcomes.
Interface professionally with data engineers, software engineers and other development teams
Troubleshoot client operational issues quickly and comprehensively
Support, train and mentor fellow analysts and developers
Influences and provides input to improvement of operational processes