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.
We are looking for a Sr. HealthRules, Facets, or QNXT Configuration Analyst with experience in Product/Benefits, Pricing, Provider, and Claims. The Sr. HealthRules, Facets, or QNXT Configuration Analyst will play an essential role in our clients' projects by leading HealthRules Facets, or QNXT configuration design, system changes, and quality assurance testing. The Sr. HealthRules, Facets, or QNXT Configuration Analyst will work with the Project team to gather and document requirements; develop or modify data, information, and functions for the Health Plan processes; including, but not limited to, benefit configuration, claims processing, clinical editing, utilization management, and enrollment.
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:
- Utilizing years of experience, designing efficient configuration solutions to meet the client's requirements and business needs
- Troubleshoots configuration and technical issues, and identifies modifications needed to meet changing user and regulatory requirements
- Reviews change requests to ensure consistency and compatibility to existing systems and procedures, including researching, validating, and resolving issues for accurate processing. Identifies, communicates, documents, and escalates information from all levels (end-users to leadership)
- Assists in the education and training of end-users. Supports development of expert users, and mentors inexperienced users
- Manages and facilitates meetings and presentations effectively and professionally to report progress and any issues. Prioritizes, plans, and organizes with Project Manager to ensure high quality results are completed on time
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:
- 5+ years of experience in configuration of product benefits, pricing, provider and claims using HealthRules Facets, or QNXT including technical knowledge of the database supporting the systems
- 5+ years of experience required in all or most of the following: Medicare, Medicaid, ACA, Commercial (small and large group)
- 3+ years of consulting experience in the Health Plan industry performing system implementations, process improvements and upgrades
- 3+ years of experience in eliciting requirements from business users to define and document project requirements, with the ability to perform business analysis and translate the outcome into definable software functionality
- Superior task management skills, with the ability to work under pressure, independently, or as part of a team in situations in which multiple priorities are likely
- Superb written and verbal English language communication skills, as well as interpersonal skills; able to communicate and influence peers, directors, and executives; to set clear expectations and realistic goals. Expert in the presentation of configuration ideas, status, solutions, and results
*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 $91,700 - $163,700 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
- 5+ years configuring product benefits, pricing, provider, and claims using HealthRules, Facets, or QNXT, including technical knowledge of the supporting database
- 5+ years of experience in most or all of Medicare, Medicaid, ACA, and commercial health plans
- 3+ years of consulting experience in the health plan industry performing system implementations, process improvements, and upgrades
- 3+ years eliciting requirements from business users, documenting project requirements, performing business analysis, and translating outcomes into software functionality
- Superior task management skills and ability to work independently or collaboratively under pressure with multiple priorities
- Excellent written and verbal English communication, interpersonal, presentation, and influencing skills
Optum Compensation & Benefits Highlights
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Parental & Family Support — Paid parental leave (six weeks), paid caregiver leave (up to two weeks), Bright Horizons back-up care, and adoption assistance up to $10,000 are prominently included. Feedback suggests these family supports meaningfully aid work-life balance and are often highlighted as strengths.
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Retirement Support — A 401(k) with company match is available to all employees, including part-time staff, alongside other financial protections like disability and life insurance. Feedback suggests broad access and matching make retirement support a core pillar of the package.
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Equity Value & Accessibility — An Employee Stock Purchase Plan offers discounted company stock, with some roles also eligible for sign-on or performance bonuses. Feedback suggests the ESPP is a standout financial perk that helps employees build ownership over time.
Optum Insights
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.