Sr. Business Analyst- C&S Maryland - Remote in EST Time zone (MD Preferred)

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together 

The Senior Business Analyst for C&S Maryland supports the health plan's relationship with state regulators by managing complex state requests, escalated member and provider issues, and oversight of delegated entities and external vendors. This role applies advanced analytical skills, operational expertise, and regulatory knowledge to resolve non standard issues, support audits and state fair hearings, and ensure compliance with Medicaid requirements.

The Senior Business Analyst operates independently, leveraging extensive knowledge of health plan policies, processes, and regulatory obligations to analyze problems, develop solutions, and drive timely resolution of escalated issues while fostering solid collaboration with internal and external stakeholders.

If you are located in EST, you will have the flexibility to work remotely* as you take on some tough challenges. Preferred for candidates to be located in Maryland due to quarterly in person meetings. 

Primary Responsibilities: 

• Assess, investigate, and resolve state customer requests, complaints, and inquiries, including escalated member issues, in accordance with Medicaid regulations, state contracts, and internal policies
• Coordinate state fair hearings, including documentation coordination, case tracking, response preparation, and collaboration with internal and external stakeholders
• Support oversight, and meeting facilitation for delegated entities and external vendors, including document collection, issue tracking, discussion of performance metrics, compliance findings, corrective actions, and operational updates
• Serve as a lead resource for internal escalated issue resolution, coordinating cross functional stakeholders to ensure timely and effective outcomes
• Foster and maintain collaborative relationships with state agencies, internal teams, delegated entities, and vendors to support operational performance and regulatory compliance
• Prepare and present analyses, findings, and written responses for oversight committees, audits, state submissions, and regulatory inquiries
• Analyze operational and regulatory data to support business planning, compliance, and development of solutions to complex operational and process issues

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: 

• 3+ years of experience as a Business Analyst or in customer service or operations leadership
• Experience gathering business or client requirements and documenting them clearly and concisely
• Demonstrated ability to research data, interpret policies or regulations, and resolve moderately complex issues
• Intermediate proficiency with PC based software and database tools, including Excel and PowerPoint
• Proven excellent written and verbal communication skills, with the ability to present complex information clearly and concisely
• Proven solid organizational skills and ability to manage multiple priorities independently
• Reside in EST time zone

Preferred Qualifications:  

• Healthcare industry experience, particularly in a managed care environment
• Experience with Medicaid regulations and/or health plan policies and procedures
• Experience supporting delegated entity oversight, audits, fair hearings, or regulatory complaints
• Reside in Maryland 

*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 $72,800 to $130,000 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.