Technical Business Analyst - Payment Integrity - Remote

UnitedHealth Group•Plymouth, MN

6h•Remote

About The Position

Optum Insight is dedicated to improving the flow of health data and information to create a more connected system, reducing friction and driving alignment between care providers, payers, and consumers. Leveraging deep industry expertise and innovative technology, Optum helps organizations reduce costs while enhancing risk management, quality, and revenue growth. As a Fortune 5 business and one of the world’s leading healthcare companies, Optum has supported global healthcare systems from Ireland and the UK for over 20 years, building a dynamic team of more than 2,100 talented individuals. This role, a Technical Business Analyst supporting Payment Integrity Business Intelligence, is critical for delivering analytics and reporting solutions for the Commercial book of business, with a primary focus on the Commercial Provider Scorecard. The position operates at the intersection of business, data, and technology, collaborating closely with Payment Integrity stakeholders, Data Engineering, and BI teams to define, document, and deliver trusted, repeatable insights that measure provider performance, payment accuracy, and integrity outcomes across the primary commercial population. Responsibilities include translating Payment Integrity and Commercial stakeholder needs into clear, actionable functional and technical requirements, ensuring alignment to established data models, governance standards, and Optum analytics platforms such as Power BI and Tableau. The role offers the flexibility to work remotely from anywhere within the U.S., with a requirement for hires in the Minneapolis or Washington, D.C. area to work in the office a minimum of four days per week.

Requirements

Experience supporting Payment Integrity, Claims Auditing, Fraud, Waste & Abuse, or Provider Performance analytics, particularly within a Commercial line of business
Hands-on experience delivering provider scorecards, operational dashboards, or performance reporting using Power BI and/or Tableau
SQL querying experience
Experience with Agile methodology including Agile tools (e.g. Rally, Jira)
Experience with analyzing and documenting requirements
Solid understanding of healthcare claims data, payment workflows, and commercial provider constructs
Adherence to UnitedHealth Group’s Telecommuter Policy (for remote employees)

Responsibilities

Partner with Payment Integrity business leads to define and refine requirements for the Commercial Provider Scorecard, including measures related to payment accuracy, audit outcomes, provider performance, and operational effectiveness
Support analytics use cases tied to the Commercial book of business, ensuring requirements reflect nuances across lines of business, provider types, and commercial contracts
Develop clear business definitions and metric logic to support consistent interpretation of scorecard measures across stakeholders
Elicit, analyze, and document business, functional, and technical requirements for Payment Integrity BI initiatives, with an emphasis on scorecard and dashboard reporting
Translate requirements into user stories and acceptance criteria aligned to Payment Integrity priorities and commercial reporting timelines
Document data flows, source-to-target mappings, and transformation logic for Commercial Payment Integrity data sets
Act as the primary liaison between Payment Integrity stakeholders and Data Engineering / BI delivery teams
Support Agile ceremonies (Sprint Planning, Reviews, Retrospectives) to ensure Commercial Provider Scorecard deliverables are well-scoped, prioritized, and understood
Actively manage risks, dependencies, and issues related to Commercial reporting deliverables
Partner with Compliance, Privacy, and Data Governance teams to ensure Commercial Provider Scorecard data adheres to contractual, regulatory, and de-identification requirements
Support data validation and UAT to ensure scorecard outputs accurately reflect Commercial Payment Integrity results before release
Contribute to governance forums to align Commercial metrics, definitions, and lineage with enterprise standards
Provide clear, concise updates to Payment Integrity and Commercial BI leadership on scorecard progress, risks, and upcoming milestones
Support executive readiness by ensuring scorecard metrics are well-documented, auditable, and explainable