Data Analyst – Remote

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

 

As a Shift Left COB (Coordination of Benefits) Data Analyst, you will play a critical role in enhancing the efficiency and effectiveness of the client onboarding process by leveraging data-driven insights. This role focuses on identifying upstream issues and implementing proactive solutions («shift left») to reduce downstream delays, improve client experience, and ensure compliance with regulatory standards. This proactive approach directly contributes to medical cost savings and enhances operational efficiency for UnitedHealthcare C&S clients. You will be responsible for analyzing a wide range of medical claim payments, comparing them against COB and Data Mining workflows, claims platforms, and provider contracts. Your work will support ideation and data-driven strategies for new claim opportunities, while also reviewing both ad-hoc and standardized reports to uncover additional savings or recommend vendor closures.

 

Success in this role requires a deep understanding of the U.S. healthcare system, particularly in areas such as reimbursement policy, provider contracting, and clinical coding. Proficiency in navigating UHG’s core claims platforms (specifically C&S) is essential. Experience in Payment Integrity, especially within the C&S line of business and Claims Operations, is highly valued. This position also demands strong collaboration with cross-functional teams, as you’ll work closely with various matrixed business partners to implement data-driven solutions that shift cost containment efforts earlier in the claim’s lifecycle. Your analytical insights and strategic thinking will play a key role in driving innovation and delivering measurable value across the organization.

 

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. 

 

Primary Responsibilities:

• Identify potential concepts for retrospective and prospective savings through individual ideation and from several perspectives such as correct network contracting, policy reimbursement, medical documentation requirements, industry and federal guidelines
• Identify root causes to shift the retrospective saving to prepay and further stages in the claim life cycle in the form of avoidance, automated prevention and manual prevention solutions
• Working collaboratively with business partners, SMEs, and BAs to ensure a shared understanding of business requirements
• Pull data of overpayment/claim paid data, sizing of Shift Left opportunity, socialization of ideas with different payment integrity solutioning teams and building relationship to deliver the result
• Examine, assess, and document business operations and procedures to ensure operational efficiency and excellence
• Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance
• Use pertinent data and facts to ideate, identify and solve a range of problems within area of expertise
• Developing and maintaining technical and user documentation
• Creating output from Excel to Power BI from data analysis for client approval
• Complying with design and coding standards, policies, and procedure
• Management concept to deployment
• Communicate the outcome of this research in a manner suitable for the intended audience
• Assist management post deployment reporting
• Work with less structured, more complex issues
• Leveraging new technologies to drive innovation in data analytics as applied to healthcare and to meet emerging customer requirements.
• Work independently
• Team player with the ability to collaborate across diverse and matrixed teams

 

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.

Required Qualifications:        

• 5+ years of data analysis and/or audit experience within the healthcare industry
• 4+ years of experience using C&S claims adjudication platforms
• 3+ years of experience in managing cross functional projects and making presentations
• 3+ years of experience pulling data using SQL, or Python
• 2+ years of experience working with processing Post-pay or Prepay payment integrity

 

Preferred Qualifications:        

• Solid organizational and interpersonal skills
• Intermediate level of proficiency in MS Excel, Word, and PowerPoint
• Working knowledge of COSMOS, FACETS
• Agile Trained (If not – agile training is required)
• Experience working in a virtual environment
• Beginner level of proficiency in MS Visio & Access

 

Soft Skills:

• Solid team player
• Excellent oral and written communication skills
• Excellent planning and organizational skills
• Ability to learn internal technology tools and systems
• Ability to navigate a complex organization to accomplish customer satisfaction
• Solid organizational and interpersonal skills
• Solid analytical & conceptual thinking skills
• Ability to communicate effectively to both technical and non-technical individuals from diverse backgrounds

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

 

The salary range for this role is $71,600 to $140,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with al minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

 

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

 

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. 

 

 

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment