Manager, Commercial Data Mining - Remote
About The Position
Optum Insight works to improve the flow of health data and information, connecting care providers, payers, and consumers through industry expertise and technology. Commercial Data Mining analyzes industry trends, payment policies, contractual agreements, and processed claims data to identify incorrect provider payments made by health insurance payers. Advanced data analytics support audit activities, validate claim accuracy and payment processes, determine overpayment causes and financial impact, and help ensure timely, accurate recoveries. As an Operations Manager on the Commercial Data Mining team, you will drive strategic ideation, establish operational standards, and optimize resource utilization. The role focuses on automating business processes, improving operational efficiency, and building client relationships in support of internal performance objectives and external financial goals. The position is remote within the U.S.; employees hired in the Minneapolis or Washington, D.C. area must work in the office at least four days per week. Remote employees must comply with UnitedHealth Group’s Telecommuter Policy.
Requirements
- At least 4 years of healthcare, health insurance, payer operations, claims, payment integrity, or related experience.
- At least 2 years of experience with healthcare coding guidelines, reimbursement policies, and payment methodologies.
- At least 2 years of experience communicating with business stakeholders, clients, or leadership.
- Understanding of healthcare claim adjudication and payer workflows.
- Understanding of EDI data, including 837 claim submission and 835 payment/remittance data.
- Ability to work independently and manage multiple priorities through completion.
- Knowledge of healthcare payment methodologies.
- Proficiency in Microsoft Office software.
- Remote employees must adhere to UnitedHealth Group’s Telecommuter Policy.
- Candidates must pass a drug test before beginning employment.
Nice To Haves
- Understanding of database logic and software.
- Employee management and leadership skills.
- Presentation skills.
- Experience with client engagement.
- Experience working within a large organization.
Responsibilities
- Ensure timely data acquisition and accuracy.
- Maintain the ideation pipeline.
- Prioritize and manage audit production efficiency.
- Drive timely recoveries.
- Assist in strategic planning and budgeting.
- Communicate with, manage, and develop staff.
- Provide reporting and attend meetings with internal and external stakeholders.
- Support internal quality assurance efforts.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs.
- Equity stock purchase plan.
- 401(k) contribution, subject to eligibility requirements.
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
Manager
Education Level
No Education Listed
