Senior Data Investigator

Reposted Yesterday
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Minnetonka, MN, USA
In-Office
60K-107K Annually
Senior level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Lead data analysis to detect potential fraud, waste, and abuse in pharmacy and medical claims. Prepare and extract claims data, produce routine and ad-hoc reports for SIU and executives, implement investigative data processes and best practices, analyze trends, and communicate findings to technical and non-technical stakeholders.
Summary Generated by Built In
Requisition Number: 2377235
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
As a Sr Data Investigator with us, you will monitor patterns of potential fraud, waste and/or abuse to ensure compliance and be closely involved in the investigation process. It will be a whirlwind, but it will also be the place where you can help make the health system work better with the support and resources of a Fortune 6 leader. If you call yourself a data guru, then you'll be perfect for this role. As you respond to inquiries, requests and actions, you'll need to be able to communicate research and data findings in a meaningful way.
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, MN; Washington, D.C.; Cypress, CA; Atlanta, GA; Metairie, LA; Columbia, MD; Richardson, TX; Draper, UT; and Wausau, WI areas, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
  • Perform data analysis and generation activities for the fraud investigations team including data extracts, summaries, random sampling, and special projects
  • Prepare pharmacy and medical claims data for investigative business needs and work with investigations teams to better understand the content of the data sets
  • Establish and implement standard policies, procedures, processes and best practices across the company to promote compliance with applicable laws and contractual obligations
  • Support the collection of data for SIU (Special Investigations Unit) activities and generate routine regulatory and executive level reports for distribution
  • Produce, publish and distribute scheduled and ad-hoc client and operational reports relating to the development and performance of products, processes and technologies
  • Analyze and interpret data to identify trends, patterns and opportunities for the business and clients
  • Communicate complex information via phone conversations and emails to non-technical clients, external customers, internal customers and executives

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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
  • Minimum of 2+ years of experience as a data analyst supporting pharmacy and/or medical claims environment or projects, etc.
  • Advanced level of proficiency with MS Excel (advanced formulas, pivot tables, macros, lists, statistical functions, etc.)
  • Intermediate level of proficiency with MS Office (Word, PowerPoint and Outlook)

Preferred Qualifications:
  • Experience working in a government, legal, health care, managed care and/or health insurance environment in a regulatory, privacy or compliance role
  • Experience working independently and researching regulations
  • Experience with VBA (visual basic for application) experience
  • Experience with Snowflake, SAS, Python, or SQL
  • Industry Certification (CFE, AHFI, CPC)

*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 $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
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.
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.
#RPO, #GREEN

Skills Required

  • Bachelor's Degree
  • Minimum 2+ years experience as a data analyst supporting pharmacy and/or medical claims
  • Advanced proficiency with MS Excel (advanced formulas, pivot tables, macros)
  • Intermediate proficiency with MS Office (Word, PowerPoint, Outlook)
  • Pass pre-employment drug test
  • Experience working in government, legal, healthcare, managed care, or health insurance in regulatory/privacy/compliance roles
  • Experience researching regulations and working independently
  • VBA (Visual Basic for Applications) experience
  • Experience with Snowflake, SAS, Python, or SQL
  • Industry certification (CFE, AHFI, CPC)

What the Team is Saying

Optum Compensation & Benefits Highlights

  • 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.
  • 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.
  • 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.

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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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