[Remote] Data Analyst - Payment Integrity - Remote

Note: The job is a remote job and is open to candidates in USA. Optum Insight helps improve the flow of health data and information to create a more connected health system. The Payment Integrity Data Analyst will build and document algorithms, analyze healthcare claims and membership data, assure data quality, and develop dashboards, business cases, and actionable insights for healthcare payer operations.

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

Skills

• 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
• Experience in COB (Coordination of Benefits) auditing
• Experience in Medicare reimbursement methodology
• Knowledge of NAIC (National Association of Insurance Commissioners) guidelines

Benefits

• Flexibility to work remotely from anywhere within the U.S., subject to the stated Minneapolis and Washington, D.C. office requirements
• A comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

Company Overview

Company H1B Sponsorship