Program Integrity Data Analyst

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. 

Optum Program Integrity Analytics is a suite of complementary, web-based components that mine provider, member and claims data for potential fraud, waste and abuse; provide software research tools; and track subsequent investigation activity.  The PI Analytics team is comprised of individuals with a variety of technical expertise from database, business intelligence reporting, and web based tools.  

The PI team is looking for a strong data-focused analyst able to quickly develop a comprehensive understanding of fraud, waste and abuse detection software. The analyst should have the ability to collaborate with multiple roles including fellow business analyst, data engineers, software engineers and report developers. This individual will be involved in many phases of an implementation project and/or an operational project and become familiar with the database structures, testing software, documentation procedure and training and User Manual formats. This role will be key in the successful implementation of new projects and the maintenance of existing projects.  

Primary Responsibilities:

• Support the full software development and implementation lifecycle  
• Analyze system requirements and technical specifications to create and execute test cases for individual application components 
• Analyze and interpret functional requests for their viability against the design of the system as well as business objectives to ensure the solution solves the business problem yet does not adversely impact the fundamentals of the system 
• Work independently, take initiative and handle multiple tasks simultaneously 
• Write test cases and execute testing within a web service environment  
• Write clear, concise, and extensive user documentation using advanced features of MS Word 
• Use advanced features of MS Excel such standard deviation, formulas and other functions 
• Plan, document, evaluate and track testing results to ensure system applications are free from defects  
• Establish and maintain test cases and test data, includes advanced knowledge of SQL 
• Actively participate in walk-through, inspection, and peer reviews  for quality assurance 
• Participate in production implementation verification and being accountable for validating system quality  
• Communicate and interact with appropriate areas on problems, changes and enhancements that may impact data, workflow and/or functionality within Information Technology software  
• Share knowledge (train) other team members and business users on any of the skills listed above

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.

Years of post-high school education can be substituted/is equivalent to years of experience.

Required Qualifications:

• 2 years fraud, waste and abuse analysis experience 
• 2 years data analysis experience, working with database structures 
• Knowledge of healthcare claims, medical terminology, medical diagnostic, procedural terms 
• Intermediate to advanced SQL skills  
• Intermediate to advanced computer skills consisting of Microsoft Excel, Outlook, Word, and Power Point

Preferred Qualifications:

• Certified Professional Coder (CPC)   
• Knowledge of Medicaid policies and data (claims, provider & member) 

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.