Senior Healthcare Business Analyst - Franklin,Tennessee

Some people take things as they come. Others relentlessly push themselves to go farther. Combine health care and technology, which are two of the fastest-growing fields on the planet, with UnitedHealth Group's culture of performance, collaboration and opportunity and this is what you get: industry-leading health care services at a company that's improving the lives of millions. As Senior Healthcare Business Analyst you will design and develop reports and analyze data to measure clinical outcomes, network performance and methodology levers. You will investigate key business problems through quantitative analyses of utilization and health care costs data. As the Consultant, you will interpret and analyze clinical data from various sources and recommend best approaches for its consolidation. Your analyses will be used to create viable, real-world solutions in a complex health care landscape. The work is as challenging as it is rewarding. You'll open doors to new opportunities. This is where bold people with big ideas are writing the next chapter in health care. Join us. There's never been a better time to do your life's best work.(sm)

Primary Responsibilities:

• Provide claims, premium, capitation and membership data in support of underwriting, Actuarial and utilization analyses


• Identify potential areas for medical cost improvements and alternative pricing strategies


• Create and update documentation for automated processes and analyst training


• Analyze reporting tools utilized by the internal customer groups


• Produce and review reports specific to risk adjustments for various markets


• Research and develop new trend opportunities with government and commercial payers

Required Qualifications

• Intermediate level of proficiency in performing data analytics


• Strong research/investigation skills


• Possess excellent time management and prioritization skills in order to meet multiple deadlines; comfortable working in a high-paced/high production area


• 1+ years of Coordination of Benefits auditing experience


• NAIC Guidelines knowledge


• Intermediate level of proficiency working with MS Excel including formulas, calculations, charts, graphs, etc.


• Experience in Medicare reimbursement methodology


• Ability to maintain understanding of numerous client processes


• Excellent critical thinking, written and verbal communication skills


• Detail oriented


• Self-driven, ability to work independently and facilitate change

Preferred Qualification:

• Bachelor's degree


• 2+ years of health care experience


• 2+ years of work experience in a corporate setting


• Basic level of proficiency with MS Access


• SAS/SQL experience


• Payer experience/knowledge


• Project Team leadership experience


• Certification of Medical coding, or 1+ years of extensive coding experience


• Strong financial analysis skills and knowledge of statistical calculation and interpretation

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)

Diversity creates a healthier atmosphere: 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.

Job Keywords: data analytics, COB, NAIC, Medicare, Medical codes, Payer, Claims data, Excel, mid-level health care economics job, math, data analysis, reporting, quantitative analysis, health care, SQL, SAS, analytics, claims, programming, economics, Tennessee, TN