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Optum
is hiring
Data Analyst, Payment Integrity
About Our Company
We’re evolving health care so everyone can have the opportunity to live their healthiest life. It’s why we put your unique needs at the heart of everything we do, making it easy and affordable to manage health and well-being. We are delivering the right care how and when it’s needed; providing support to make smarter and healthier choices; and making prescription services easier, while helping you save money along the way. It’s everything health care should be. Together, for better health.
Job Description & Responsibilities
Primary Responsibilities:
Research and identify areas for non-clinical medical cost improvements and alternative pricing strategies with government and commercial healthcare payers
Interpret and analyze claims and membership data
Write complex SQL queries to execute against large healthcare payer data sets
Create and update automated database processes
Analyze reporting utilized by internal customer groups
Use logical, detail-oriented thought process to break down complex problems into individual sequential steps and identify root causes
Identify and refine criteria to successfully increase efficiency of algorithm logic
Contribute to analytic opportunities that may include proof of concept, functional testing, determination of yield, time to complete, and financial impact
Explore potential trends identified by matrix business partners
Use business requirements for process automation, analytic development, strategic reporting, and system navigation.
Execute standalone production processes
Triage anomalies observed with production processes
Requirements
Required Qualifications:
2+ years of experience in a corporate setting
2+ years of experience performing data analytics, including identifying trends in large data sets
2+ years of experience reading and writing complex SQL statements/queries
2+ years of experience with MS Excel, including pivot tables, formulas, calculations, charts, graphs, etc.
2+ years of experience working from business requirements documents
Preferred Qualifications:
Experience in COB (Coordination of Benefits) auditing
Experience in Medicare reimbursement methodology
Knowledge of NAIC (National Association of Insurance Commissioners) guidelines
What we offer
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 $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
