Claims Business Analyst

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 Claims Business Analyst 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 Telecommuters 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.

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