Senior Clinical Analyst

UnitedHealth Group • San Antonio, TX

149d • $71,200 - $127,200 • Onsite

About The Position

Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. Connecting. Growing together. The Sr Clinical Analyst will work within the Suspect Services Team focusing on clinical suspecting, Machine Learning, and clinical actions. This role will perform healthcare data analysis, interpretation and monitor data trends to present to the team, leaders and stakeholders in order to support and drive the business needs.

Requirements

• Registered or Licensed Vocational Nurse.
• 2+ years of Clinical Analytics experience.
• 2+ years of process improvement experience.
• 2+ years of healthcare experience in one or more of the following areas: Claims Processing/Analysis, Medical Billing, Medical Coding, Nursing, Medical Assistant, Clinical Operations.
• 1+ years of advanced experience using Microsoft office applications, including databases, word-processing.
• 1+ years of advanced experience using Visio® and Excel®.
• Proven excellent presentation skills with solid communication capabilities and practices, both oral and written.

Nice To Haves

• Associate or bachelor's degree.
• Certified Professional Coder.

Responsibilities

• Perform or oversee the research, interpretation, and analysis of pertinent healthcare data to identify new business opportunities and drive business decisions.
• Report monthly metrics relating to variances and efficacy of clinical suspects and actions to business leaders.
• Liaison between clinicians, business and IT teams.
• Work closely with associated IT teams to gather, analyze and report clinical and Machine Learning data.
• Works with Lead Clinical Analyst to prepare and report analysis to leaders for short and long term operational/strategic business activities.
• Define user acceptance testing, assist with team coordination of system changes, and system upgrades.
• Analyze data trends and create documentation to support all reports, conduct quality monitoring to ensure data accuracy and reliability.
• Works with the Lead Clinical Analyst to determine recommendations based on data analysis and provide explanations for reporting results as needed.
• Build and maintain solid relationships with business partners to effectively gather requirements and ensure business expectations are met.
• Identify challenges and opportunities, develop solutions and communicate to business leaders and internal stakeholders.
• Oversee the documentation of data processes, analytical methodologies and dashboard logic to ensure transparency, reproducibility and team alignment.
• Develop and implement process improvements in team and application processes.
• Perform all other related duties as assigned.

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase.
• 401k contribution.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Associate degree