Operations Manager, Commercial Data Mining - Remote

UnitedHealth Group•Plymouth, MN

6d•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. Commercial Data Mining focuses on analyzing industry trends, payment policies, contractual agreements, and processed claims data to identify incorrect provider payments made by health insurance payers. Advanced data analytics are developed to support audit activities, validating claim accuracy and payment processes to determine both the root cause and financial impact of overpayments. Our teams ensure recoveries are executed accurately and in a timely manner, delivering measurable value to our clients. As an Operations Manager on the Commercial Data Mining team, you will drive strategic ideation, establish operational standards, and optimize resource utilization. This role focuses on automating business processes, improving operational efficiency, and building solid client relationships to support both internal performance objectives and external financial goals. 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

4+ years of healthcare experience
Understanding of healthcare claim adjudication and payer workflows
Solid understanding of EDI data (837/835)
Knowledge of healthcare coding guidelines and reimbursement policies
Knowledge of healthcare payment methodologies
Demonstrated proficiency in Microsoft Office software
Demonstrated solid verbal and written communication skills
Demonstrated solid client facing experience and the ability to deliver clear, professional client presentations
Demonstrated ability to work independently