Operations Manager, Commercial Data Mining – Remote

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.

Commercial Data Mining focuses on analyzing industry trends, payment policies, contractual agreements, and processed claims data to identify incorrect provider payments made by health insurance payers. Advanced data analytics are developed to support audit activities, validating claim accuracy and payment processes to determine both the root cause and financial impact of overpayments. Our teams ensure recoveries are executed accurately and in a timely manner, delivering measurable value to our clients.

As an Operations Manager on the Commercial Data Mining team, you will drive strategic ideation, establish operational standards, and optimize resource utilization. This role focuses on automating business processes, improving operational efficiency, and building solid client relationships to support both internal performance objectives and external financial goals.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities:

• Ensure timely data acquisition and accuracy
• Maintain ideation pipeline
• Prioritize and manage audit production efficiency
• Drive timely recoveries
• Assist in strategic planning and budgeting
• Effectively communicate with, manage, and develop staff 
• Provide reporting and attend meetings with internal and external stakeholders
• Support internal quality assurance efforts

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:

• 4+ years of healthcare experience
• Understanding of healthcare claim adjudication and payer workflows
• Solid understanding of EDI data (837/835)
• Knowledge of healthcare coding guidelines and reimbursement policies
• Knowledge of healthcare payment methodologies
• Demonstrated proficiency in Microsoft Office software
• Demonstrated solid verbal and written communication skills
• Demonstrated solid client facing experience and the ability to deliver clear, professional client presentations
• Demonstrated ability to work independently

Preferred Qualifications:

• Experience with client engagement
• Experience working within a large organization
• Solid understanding of database logic and software
• Demonstrated employee management and leadership skills
• Demonstrated solid presentation skills

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

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 $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.