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Senior Business Systems Analyst - Remote
Plymouth, Minnesota
Caring. Connecting. Growing together.
With these values to guide us, our people are committed to making a meaningful difference in the lives of those we are honored to serve.
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.
We are recruiting for a Senior Business Systems Analyst - Remote to join our Optum Application Managed Services (AMS) team. The AMS team engages in short- and long-term commitments and partnerships and provides full service operational support to our clients with a proactive approach to business communication, efficiency, and problem resolution. The AMS team partners with health plan clients to become an extension of their organization. The highly seasoned staff is dedicated to managing Prospective Payment Systems (PPS) as well as looking at where PPS fits in the clients "Ecosystem." AMS provides services that will help provide long term benefit for the client, not only direct resource savings, but also savings in process, manual effort and other operational areas.
The Senior Business Systems Analyst is responsible for ensuring effective delivery of ongoing maintenance, supporting integration, configuration, and migration efforts. Business Systems Analysts are measured on service quality, systems knowledge development, and relationship building within assigned client portfolio. Additionally, the Business Systems Analyst may be responsible for project planning, client reporting, NPS improvement, and client by client SLA tracking.
The Senior Business Systems Analyst must also have the ability to facilitate internal or external meetings and drive effective solutions. The successful Business Systems Analyst candidate will have solid communications skills and the ability to liaison between technical and claims operations personnel.
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:
- Ensures successful installation, implementation, configuration and integration
- Work with Optum customers and vendor partners on configuration, use, and troubleshooting of Optum Web Service and Payment System Interface Cloud solutions
- Apply analytical / quantitative approach to problem solving
- Experience on obtaining and using PPS data for troubleshoot and analysis
- Comfortable and actual experience with statistical concepts to assist with PPS claims analysis
- Utilize communication skills to influence and negotiate
- Utilize one's solid interpersonal skills to work with all levels of management across all functional areas, as well as, business partners through internal entities
- Work within client ticketing system to track escalated issues, input new issues or answer issues sent in by other teams. Communicate any responses back to client and ensure understanding of the content
- Implement changes as needed and outlined in contract
- Work directly with Optum colleagues and customers to document and deliver Client PPS payment system methodology education needs
- Work directly with Optum colleagues and clients to document and deliver Client requirements for Optum PPS product training
- Works directly with customers to define other project requirements, provide assistance to answer questions related to project results
- Assist as needed with other Reimbursement Solutions projects Engage with dedicated clients either VPN or Remote, WebEx to apply updates or Troubleshoot issues using documentation from Regulatory
- Supports Optum Business Partners with technical implementation and integration questions. Offers recommendations for interface improvements from a technical perspective
- Compile Documentation: Processes and Procedures (including but not limited to Clients specific tracking, network configuration, rules of engagement)
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 experience working in a healthcare data or regulatory environment
- 3+ years of experience with installing, troubleshooting, and using Optum's EASYGroup, Web Services, WebStrat, Optum Payment System Interface, and/or Rate Manager
- 3+ years of experience in pricing Medicare hospital facility claims (inpatient and outpatient)
- Claims system experience - Homegrown claims system (specify), Trizetto Facets, NetworXks Pricer, QNXT, Health Rules Payer, IKA Claims, Burgess Systems, Epic Tapestry, 3M preferred
- Experience breaking down information and developing solutions
- Health plan experience in facility contract configuration, claims or IT
- Experience documenting client operational and technical workflow
- Experience configuring and customizing software solutions
- SQL experience writing queries, navigating DBs, and researching data
- Experience with installing, troubleshooting, and navigating RESTful Web Services
- Experience with healthcare claims data, PPS concepts, UB04 and HCFA 1500 claim content
- Proven experience with using .NET and IIS
- Basic knowledge and understanding of Prospective Payment Systems - includes DRG, APC, OCE, ESRD, CAH, CMG, RUG, RBRV
- Facility claims reimbursement knowledge - Medicare, Medicaid, Commercial
- Intermediate knowledge and usage of with Microsoft Word, Excel, PowerPoint, Visio
Preferred Qualifications:
- Some SQL experience
- Python experience
- Experience in API's
- Experience in Postman
*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.
Benefits
Our mission of helping people live healthier lives extends to our team members. Learn more about our range of benefits designed to help you live well.
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Resources and support to focus on what matters most to you, in every facet of your life.
Emotional
Education, tools and resources to help you reduce and manage stress, build resilience and more.
Physical
Health plans and other coverage to support wellness for you and your loved ones.
Financial
Benefits for today and to help you plan for the future, including your retirement.
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