The Role
Analyzes healthcare business and system requirements, creates functional specifications and process documentation, supports implementations and integrations, troubleshoots production issues, performs testing and defect triage, and identifies workflow improvements. The role collaborates with technical and business stakeholders on Agile healthcare technology initiatives, cloud modernization, regulatory compliance, healthcare data analysis, and payer-related systems.
Summary Generated by Built In
Requisition Number: 2391493
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
Primary Responsibilities:
Required Qualifications:
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
Primary Responsibilities:
- Gather, document, and analyze business and system requirements
- Translate business needs into functional specifications, user stories, and system designs
- Conduct impact assessments for system enhancements, integrations, and regulatory changes
- Create process flows, data mappings, interface specifications, and business requirement documents
- Collaborate with business users, architects, developers, QA teams, and product owners to deliver healthcare solutions
- Support system implementations, upgrades, and modernization initiatives
- Perform root cause analysis and troubleshoot production issues
- Validate system functionality through testing, UAT support, and defect triage
- Analyze healthcare data and workflows to identify process improvement opportunities
- Support system integration initiatives involving healthcare applications and third-party platforms
- Ensure compliance with healthcare regulations, policies, and organizational standards
- Participate in Agile ceremonies including sprint planning, backlog refinement, and retrospectives
- Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
Required Qualifications:
- Bachelor's degree in computer science, Information Systems, Healthcare Administration, Engineering, or related fields
- 4+ years of experience as a System Analyst, Business Analyst, or Technical Analyst
- Experience in US Healthcare domains, including Health Insurance / Payer, Provider Operations, Population Health, Care Management, Claims Processing, Revenue Cycle Management etc
- Solid experience in requirements gathering and documentation, Ability to create BRDs, FR, User Stories, Process Flows, Data Mapping Documents
- Traceability Matrices experience
- Experience with Agile/Scrum methodologies and tools such as JIRA, Rally, or Azure DevOps
- Good hands-on experience in tools like Tools - JIRA,Azure DevOps,Rally,Visio,Power BI and Microsoft Office Suite
- Experience with cloud platforms such as Azure or AWS
- Experience supporting digital transformation or cloud migration programs
- AI/ML or Generative AI exposure in healthcare workflows
- Healthcare Domain Knowledge is must with good Experience in payer business functions like Claims Adjudication, Benefits Configuration, Provider Management, Membership Administration, EDI Transactions, Care Management etc.
- Solid understanding of Healthcare Standards- HIPAA,ICD-10,CPT,HCPCS,HL7,FHIR,X12 EDI (837, 834, 835, 270/271)
- Knowledge of healthcare analytics and automation
- Proven solid SQL skills for data analysis and troubleshooting
- Proven excellent communication and stakeholder management skills
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Skills Required
- Bachelor's degree in computer science, information systems, healthcare administration, engineering, or a related field
- 4+ years of experience as a system analyst, business analyst, or technical analyst
- Experience in U.S. healthcare domains such as health insurance or payer operations, provider operations, population health, care management, claims processing, or revenue cycle management
- Experience gathering and documenting requirements, including BRDs, functional requirements, user stories, process flows, and data mapping documents
- Experience with traceability matrices
- Experience with Agile/Scrum methodologies and tools such as JIRA, Rally, or Azure DevOps
- Hands-on experience with JIRA, Azure DevOps, Rally, Visio, Power BI, and Microsoft Office Suite
- Experience with cloud platforms such as Azure or AWS
- Experience supporting digital transformation or cloud migration programs
- Exposure to AI, machine learning, or generative AI in healthcare workflows
- Healthcare domain knowledge, including payer functions such as claims adjudication, benefits configuration, provider management, membership administration, EDI transactions, or care management
- Understanding of healthcare standards including HIPAA, ICD-10, CPT, HCPCS, HL7, FHIR, and X12 EDI transactions
- Knowledge of healthcare analytics and automation
- Strong SQL skills for data analysis and troubleshooting
- Excellent communication and stakeholder management skills
Optum Compensation & Benefits Highlights
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Leave & Time Off Breadth — PTO is generally described as decent or good, and many note it as a strong part of the package. Actual ability to take time off can depend on workload and team coverage.
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Retirement Support — Offerings include a 401(k) with employer match and access to an employee stock purchase plan, which are highlighted as meaningful components of total rewards. These programs are consistently referenced among core benefits.
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Parental & Family Support — Parental and caregiver leave, along with adoption assistance, are publicly highlighted and viewed as notable elements of the package. Availability can be role-specific, but these supports contribute to overall breadth where offered.
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The Company
What We Do
Optum, part of the UnitedHealth Group family of businesses, is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.
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Optum Offices
Hybrid Workspace
Employees engage in a combination of remote and on-site work.
Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.
Typical time on-site:
Not Specified
