Lead Business Systems Analyst - Minneapolis, MN

UnitedHealth Group•Minneapolis, MN

2d•Hybrid

About The Position

Optum Tech is a global leader in health care innovation. Our teams develop cutting-edge solutions that help people live healthier lives and help make the health system work better for everyone. From advanced data analytics and AI to cybersecurity, we use innovative approaches to solve some of health care’s most complex challenges. Your contributions here have the potential to change lives. Ready to build the next breakthrough? Join us to start Caring. Connecting. Growing together. 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

8+ years of Business Analysis experience
5+ years of experience supporting the healthcare domain
5+ years of experience in a leadership, decision-making, and stakeholder management skills
3+ years of experience interpreting claims adjudication rules, payment policies, or benefit structures
Experience in Claims PI, FWA, Provider Contracting, Billing, or RCM
Ability to work onsite in Minneapolis per Optum’s hybrid policy

Nice To Haves

Bachelor’s degree in Business, Health Administration, Finance, or related field
Excellent analytical and problem-solving skills
Exceptional written and verbal communication
Solid time management; ability to handle multiple priorities
Proven ability to work independently and collaboratively
Medicare / Medicaid domain depth
SQL for data exploration, validation, and reporting
Familiarity with PBM, eligibility logic, or provider credentialing systems

Responsibilities

Lead end-to-end business analysis efforts across claims adjudication, payment integrity reviews, appeals, audit recovery, and FWA investigations
Drive revenue-based opportunity identification, including duplicate claims detection, pricing/contract errors, eligibility misalignment, underpayment/overpayment root causes, and leakage prevention
Serve as the primary liaison between business sponsors, PI SMEs, actuarial partners, provider teams, and technical build teams
Interpret healthcare guidelines, policies, contract rules, and benefit logic and translate them into actionable business rules and functional requirements
Lead formulation, validation, and refinement of requirements, acceptance criteria, and business rule logic for PI interventions
Review data quality, impact assessments, and financial projections across PI initiatives
Mentor and guide Business Analysts, ensuring consistency, analytical rigor, and adherence to documentation standards
Lead complex issue remediation: deep-dives into claim-level patterns, provider-level anomalies, pricing variances, member eligibility mismatches, and systemic process gaps
Support leadership-level reporting, audit responses, regulatory inquiries, and controls documentation
Participate in roadmap design, prioritization sessions, operational reviews, and cross-functional working groups