Senior Business Analyst - Remote (107445856)
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
This position will help manage the SAM Edit program for the Medicare and Retirement business. The candidate will be responsible for ensuring automations are produced and maintained, accurately, timely, and follow CMS guidelines. They will be required to do analysis to ensure return on investment on all projects. They will also be required to maintain tracking and trending of current edits in place to ensure efficient use of resources.
Positions in this function are responsible for investigating and resolving all types of claims as well as resolution for health plans and government entities.
Investigate payables on subrogation claims and file management. Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance. May conduct contestable investigations to review medical history. May monitor large claims.
- Reviews the work of others.
- Develops innovative approaches.
- Sought out as expert.
- Serves as a leader/ mentor.
- Detail oriented.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am – 5:00pm. It may be necessary, given the business need, to work occasional overtime or weekends.
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.
- Bachelor's Degree (or higher) OR equivalent experience
- 3+ years of experience utilizing COSMOS; i.e. someone who is familiar with pricing claims and handling claims adjudication
- 2+ years of Medicare Payment Policies and Payment Methodologies
- Intermediate to advanced level of proficiency with MS Word, Excel, and PowerPoint (Word – creating documents and tables; Excel – data analytics, creating pivot tables, creating formulas and calculations, etc.; PowerPoint – creating slide show presentations from scratch)
- Back-end data table experience within COSMOS
- Configuration experience
- SQL experience is preferred
- Experience in creating documents for projects (i.e. PRD, Process Flow, Testing Documents)
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy
- Ability to keep all company sensitive documents secure (if applicable)
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
- Excellent verbal and written communication skills; i.e. this person must be able to embody great communication skills as they will possibly be engaging with all levels of management and navigating vendors and such
UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.
Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military
Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.SM
Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $64,800 - $116,000. The salary range for Connecticut / Nevada residents is $71,400 - $127,400. 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.
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