Data Analyst - Payment Integrity - Remote

Posted Yesterday
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Hiring Remotely in Brentwood, TN, USA
In-Office or Remote
73K-130K Annually
Junior
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Analyze healthcare claims and membership data to build and document algorithms, create dashboards and visualizations, write complex SQL, automate database processes, interpret results, triage production anomalies, and present actionable insights to support payment integrity initiatives.
Summary Generated by Built In
Requisition Number: 2366528
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.
As a Payment Integrity Data Analyst, you will be responsible for building and documenting targeted algorithms, conducting analyses of health care membership and cost data, and assuring data quality. As a PI DA you will partner with stakeholders to understand data requirements and develop algorithms for inventory creation, dashboards, data visualizations, decision aids, and business case analysis to support the business and underlying client agreements. Documentation includes creating specifications for product or process builds, creating business requirements or process flows, interpreting results, developing actionable insights, and presenting recommendations for business use. Team members use business intelligence, data visualization, query, and analytic software to build solutions, perform analysis, and interpret data. PI DAs contribute their subject matter expertise in the design of analytics and algorithms.
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.
Primary Responsibilities:
  • Research and identify areas for potential non-clinical medical cost improvements and alternative pricing strategies with government and commercial payers
  • Interpret and analyze claims and membership data
  • Write complex SQL queries to execute against large healthcare payer data sets
  • Create and update automated database processes
  • Analyze reporting utilized by internal customer groups
  • Use logical, detail-oriented thought process to break down complex problems into individual root causes
  • Identify and refine criteria to successfully increase efficiency of algorithm logic
  • Contribute to analytic opportunities that may include proof of concept, functional testing, determination of yield, time to complete, and financial impact
  • Explore potential trends identified by matrix business partners
  • Use business requirements for process automation, analytic development, strategic reporting, and system navigation.
  • Execute standalone production processes
  • Triage anomalies observed with production processes

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.
Required Qualifications:
  • 2+ years of experience in a corporate setting
  • 2+ years of experience performing data analytics, including identifying trends in large data sets
  • 2+ years of experience reading and writing complex SQL statements/queries
  • 2+ years of experience with MS Excel, including pivot tables, formulas, calculations, charts, graphs, etc.
  • 2+ years of experience working from business requirements documents

Preferred Qualifications:
  • Experience in COB (Coordination of Benefits) auditing
  • Experience in Medicare reimbursement methodology
  • Knowledge of NAIC (National Association of Insurance Commissioners) guidelines

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants
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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Skills Required

  • 2+ years of experience in a corporate setting
  • 2+ years performing data analytics, including identifying trends in large data sets
  • 2+ years reading and writing complex SQL statements/queries
  • 2+ years experience with Microsoft Excel (pivot tables, formulas, charts, graphs)
  • 2+ years working from business requirements documents
  • Experience in COB (Coordination of Benefits) auditing
  • Experience in Medicare reimbursement methodology
  • Knowledge of NAIC (National Association of Insurance Commissioners) guidelines

What the Team is Saying

Optum Compensation & Benefits Highlights

  • Healthcare Strength Health coverage offers copay and HSA medical options with dental, vision, company‑paid life and disability, and free or low‑cost virtual visits. Feedback suggests the offering is comprehensive and competitive on paper.
  • Parental & Family Support Time off and family supports include PTO, eight paid holidays plus a floating day, six weeks paid parental leave, up to two weeks paid caregiver leave, Bright Horizons back‑up care, and adoption assistance up to $10,000. Feedback suggests these resources are meaningful for caregivers and family needs.
  • Retirement Support Savings programs include a 401(k) with employer match (after one year, vesting after two) and a 10%‑discount Employee Stock Purchase Plan. These programs bolster long‑term financial security when combined with other savings resources.

Optum Insights

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The Company
HQ: Eden Prairie, MN
160,000 Employees
Year Founded: 2011

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
HQEden Prairie, MN
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