If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life’s best work.(sm)
Clinical Performance (CP) is charged with effectively implementing, monitoring, and executing on clinical documentation, quality, and affordability programs that promote patient health while improving the provider practice experience with a special focus on Medicare Risk Adjustment and HEDIS. Clinical Performance processes on a national level by providing support in all markets served by OptumCare Delivery.
People say change is hard. We say so what? We're in the business of making health care more affordable, simpler and easier for people to access. And we need really smart business professionals who can help us. As a Senior Business Analyst, you'll design processes and project implementations and diagnose process improvement opportunities as you develop innovative solutions that will affect millions. If that sounds energizing to you, join us today
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Develop/Support Solution Strategies and Plans
- Perform appropriate research/analyses to help develop solutions to support CP Risk Adjustment Operational processes
- Create business requirements to drive development of solutions to support CP Risk Adjustment Operational processes
- Oversee management of key Risk Adjustment data operation processes within CP Risk Adjustment Operational processes
- data environment
- Oversee enforcement of SLA and controls to ensure timely and accurate completion of data processes
- Oversee level 1 triage of data processing and manage the escalation and mitigation plan for any issues
- Perform data analysis and provide insights based on the analysis and findings
Develop/Manage Client Relationships
- Establish productive relationships and clear lines of communications with CP team members relevant CDO stakeholders.
Demonstrate Market and Industry Knowledge
- Stay current on important issues in the healthcare industry.
- Demonstrate knowledge of CMS Risk Adjustment and ICD-10 coding requirements and regulations. Stay abreast of changes/updates in relevant policies, procedures and regulations.
- Leverage knowledge of the market and industry to drive service excellence and Risk Adjustment performance.
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 equivalent experience
- 5+ years of healthcare experience
- 3+ years of Risk Adjustment experience
- Solid SQL skills, ability to perform effective querying involving multiple tables and subqueries
- Ability to apply business knowledge to findings and provide insights
- Ability to understand process workflow and triage production issues
- Ability to work with business stakeholders and document functional and business requirements
- Experience working in Agile development environment
- Technical competency with experience creating and applying data analytics to solve business problems
- Excellent verbal and written communication skills
- Ability to work with offshore teams
- Customer/consultant relationship management and collaboration skills
- Knowledge of Software Development Life Cycle methodologies. Working knowledge of data mining principles: predictive analytics, mapping, collecting data from multiple data systems on premises and cloud-based data sources
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Colorado, Connecticut or Nevada Residents Only: The Salary range for Colorado residents is $82,100 to $146,900. The Salary range for Connecticut/Nevada residents is $90,500 to $161,600. 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.