Data Engineer, Payment Integrity - Telecommute at Optum

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Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work.(sm)
The Data Engineer, Payment Integrity is responsible for providing data analytic support and reporting to address payment integrity needs. They will work closely with clinical and operational staff to translate clinical requirements and goals into analytic solutions for business problems.
This position plays an important role in the development and implementation of business intelligence that addresses and improves payment integrity. Under limited supervision, this position will acquire required data from complex data sources, ascertain and execute analytic plans and statistical models/processes (including sampling, extrapolation, longitudinal modeling, and forecasting). This position will use analytic results to recommend next steps and prioritize areas of focus for clinical partners.
Will produce both ad hoc and reoccurring reporting to address clinical and operational needs and proactively identify areas of payment integrity risk. Will ensure data architecture is implemented to support alignment with business requirements. May coordinate efforts between or within teams for smaller work efforts.
You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
  • Designs, develops, tests, documents and maintains database queries and reports related to payment integrity
  • Works with internal and external department customers to define and document requirements to enrich reporting capabilities
  • Develops systematic reporting processes and procedures to ensure timely delivery of daily, weekly, monthly, annual and ad hoc reporting to management and clinical partners
  • Troubleshoots data integrity issues, analyzes data for completeness to meet business goals and trending
  • Produces dynamic analytic summaries and visualizations that convey complex analytic problems and solutions in a way that is accessible to non-technical customers
  • Recommends and implements new or modified reporting methods and procedures to improve report content and completeness of information
  • Supports complex projects that require cross functional coordination, particularly with clinical and claims operational staff. Works closely with all customers to accomplish mutual goals and strategies in order to support company goals
  • Serves as a resource to operational claims and clinical staff, answering questions and assisting with department informatics, reporting and trending, and workflow/operational issues
  • Escalates issues to department leadership for support and guidance
  • Performs analysis by developing and executing queries on various sets of data streams, and evaluates downstream business systems, processes, and/or organizational impacts
  • Assists in the development and testing of new reports and ongoing support of existing solutions, including defect identification and resolution
  • Advises on the implications of existing systems that can be applied to a reporting problem. Identifies risks and issues, and seeks approval on complex matters
  • Checks, instructs, and otherwise functionally directs technical staff in order to achieve desired end-results on complex problems regarding payment integrity
  • Collaborates with leadership to identify highest value analytics projects that support strategic business goals. Develops project timelines, communicates with customers, and cascades top priority projects to team members to meet project deliverables and customer expectations
  • Assists in statistical functions and makes recommendations on processes, including: sample size and power calculations, extrapolation, and longitudinal analyses
  • Performs all other related duties as assigned

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:
  • Bachelor's degree in Mathematics, Statistics, Data Science, or related field (4 additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelor's degree)
  • 3+ years of analytic experience
  • Experience with health plan or health care administration data
  • Proficiency in developing efficient, well performing queries in SQL, R, or Python (or equivalent query language)
  • Knowledge of analytics platforms and data visualization tools, including but not limited to: R, SAS, Python, and Tableau
  • Expert knowledge of Microsoft Word, Excel, Access and Visio software applications

Preferred Qualifications:
  • Familiarity with relational databases
  • Familiarity with program or payment integrity initiatives, especially claims data and supporting data, analytics and documentation around claims administration and adjudication
  • Prior experience with data science libraries in R, Python, SAS, or equivalent
  • Comfort with statistical and machine learning libraries
  • Salesforce development experience

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.
Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Colorado Residents Only: The salary range for Colorado residents is $64,800 to $116,000. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: The Data Engineer, Payment Integrity, Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote, Long Beach, CA, California, Chicago, IL, Illinois, Atlanta, GA, Georgia, Tulsa, OK, Oklahoma, Seattle, WA, Washington
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