Sr. Business Analyst - Telecommute

You believe data can help reshape the future, and you find yourself loving the thrill of diving into challenging analysis. At UnitedHealth Group, you'll find an organization that will recognize those talents and have lots of growth potential. Here, you will be empowered, supported and encouraged to use your analysis expertise to help change the future of health care. Does the challenge intrigue you? As a key member of the Analyst team, you will be part of UnitedHealth Group's mission of helping people live healthier lives. As a Senior Business Analyst, you will grow and develop as you conduct and manage outcomes of various studies. You will be challenged to analyze, review, and forecast data for operational and business planning. As part of this elite team, you will be empowered to impact the health care system through the analysis and interpretation of data, and presenting recommendations for business solutions. Join us! There's never been a better time to do your life's best work.(sm) Primary Responsibilities:

Support multiple data reconciliation programs including but not limited to:

Claims and ASMs to CMS RAPs - this will ensure that all claims and supplemental chart review data is successfully submitted to CMSRAPs to EDS - this will enable us to ensure that all codes sent via RAPs are also submitted via EDS for risk adjustment payment; this effort will also mitigate ASM (supplemental dx code) revenue at risk, which is 10 percent of all ASM revenue for 2015 dates of service and 25 percent of all ASM revenue for 2016 dates of service
EDS to RAPs - this will ensure that codes identified and submitted via EDS are also captured in the RAPs process; ASM revenue impact is 90 percent of total from 2015 dates of service and 75 percent from 2016 dates of service
Attestation to Claims - this will enable us to ensure that all codes identified in attestations are successfully submitted on claims and ensure that health-conditions are sent to CMS are comprehensive
Dual Status - this will ensure that our members who have dual status (i.e. Medicaid and Medicare) are coded correctly as duals
Compliance with EDS linking requirements - this will ensure that all of our supplemental chart review data successfully links to original claims and compliance with guidelines proposed by CMS

Required Qualifications:

Bachelors degree or greater or equivalent experience
5+ years of previous Business Analysis experience
5+ years of previous data analysis, process documentation, and process improvement experience
5+ years of previous experience interacting with business leadership
5+ years of SQL query development experience includuing tables, views, indexes, and stored procedures.
5+ years combined experience within managed care / health insurance industry experience in government relations, network management, and / or legal / compliance
Experience with SSIS and SSRS
Experience in handling and managing large volumes of data
Proficiency with Microsoft Office
10% travel required
Preferred Qualifications:

Familiarity with government pay for performance programs
Experience in Risk Adjustment
Experience and knowledge of health and medical data
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: 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.
 
 
Job Keywords: business analysis, data analysis, healthcare industry experience, telecommute, telecommuter, telecommuting, remote, work from home