Lead, Data Analysis - Payer Claims - Remote

$104,700 - $190,400/Yr

UnitedHealth Group - Eden Prairie, MN

Full-time - Mid Level

Remote - Eden Prairie, MN

Insurance Carriers and Related Activities

About the position

Optum 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 diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. This role will sit in the Optum Advisory organization within Optum Insight. You will be part of Risk Management & Insights team, specializing in Trend Analytics & Payment Innovation. You will be part of a team responsible for developing specifications which measure medical cost savings associated with Optum Insight cost management payments. You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Responsibilities

• Provide guidance, leadership and mentorship to existing team members
• Lead projects and manage them independently
• Oversee and maintain custom code bases for 17+ clients on 2 tech platforms
• Analyze large datasets to ensure accurate application of SQL logic and calculations
• Identify/research/resolve logic breaks, bugs, and enhancements independently by partnering with SMEs
• Develop detailed business and technical requirements to change/refine code and logic
• Collaborate with data engineers to create new repeatable data ETL processes and/or update existing ETL processes
• Conduct data profiling and analysis using source data to meet business requirements
• Design and perform QA checks and thorough end-to-end testing to confirm accurate savings calculations
• Maintain high performance and quality through ongoing remediation testing and post-production monitoring
• Perform robust regression and UAT testing accompanied by detailed documentation and test plans
• Continuously refine quality control measures and automated processes
• Manage and understand complex and high-volume daily production data processes
• Communicate impacts (savings, claim volumes, etc.) with internal and/or external stakeholders

Requirements

• 5+ years of hands-on data analysis of health insurer's medical eligibility/membership and medical claims data; including writing ad hoc SQL against a data warehouse that contains large volumes of data from a variety of different sources
• 5+ years of Business Analyst experience - gathering requirements and writing functional data specifications
• 3+ years of hands-on experience with at least one of the following database technologies: Oracle, SQL Server, DB2, Teradata, Snowflake
• 3+ years of hands-on experience querying data in a data warehouse that contains large volumes of data from a variety of different sources
• Hands-on experience writing SQL statements using the following commands in a relational database: GROUP BY, SUM, HAVING, JOIN, WHERE
• Experience with Microsoft Excel, including experience creating pivot tables and writing functions (e.g. SUM, VLOOKUP, CONCATENATE, etc.)
• Expert level in reading and writing SQL code to understand data creation

Nice-to-haves

• Experience supporting data production processes that refresh on a regular cadence
• Experience establishing database connections with query tools (e.g. Toad, Dbeaver, DBVisualizer, etc.)
• Claim processing experience across different platforms
• Demonstrated awareness of when to appropriately escalate issues/risks
• Demonstrated excellent communication skills, both written and verbal
• Demonstrated ability to work independently to conduct analysis, and then summarize and review findings with others
• Demonstrated ability to collaborate with data engineers, actuarial staff, project leads and manager
• Demonstrated ability of attention to detail and critical thinking skills

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution