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Business Analyst Consultant- Sacramento, CA

Sacramento, California

Caring. Connecting. Growing together.

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Business Analyst Consultant- Sacramento, CA

Requisition number: 2352974 Job category: Business & Data Analytics Primary location: Sacramento, CA Date posted: 04/08/2026 Overtime status: Exempt Travel: No

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.

Position Highlights and Responsibilities:

We are seeking a highly motivated Case Development Specialist with experience in healthcare fraud, waste and abuse (FWA) investigations having worked in a Program/Payment Integrity (P.I.) or prior Special Investigations Unit (SIU) to support program integrity initiatives within the Medi Cal (Medicaid) program, supporting the Department of Health Care Services (DHCS) Audits and Investigation (A&I). This role is ideal for an analytical professional who excels in data mining, case development, and presenting complex findings to diverse stakeholders.
The selected candidate will collaborate closely with internal teams, leadership, and the California Department of Health Care Services (DHCS) Audits & Investigations (A&I) staff to identify, analyze, and present potential fraud, waste, and abuse cases. Strong written and verbal communication skills are essential.
Key Responsibilities:

Prevent and identify potential healthcare fraud, waste and abuse (FWA) using complex algorithms, a Fraud and Abuse Detection System (FADS), and Cognos based fraud detection system, and analytical tools such as BusinessObjects, Power BI, SQL, or SAS
Creating and/or assisting with algorithm ideation to support and conduct data mining to detect fraudulent, wasteful, or abusive provider patterns within the Medi Cal program
Prepare and present well documented, clearly summarized case findings to DHCS and A&I staff for potential case acceptance
Provide analytical and reporting support for ongoing fraud and abuse investigations
Review and provide feedback on case summaries and reports developed by team members
Deliver focused, on site consultation to program areas related to fraud and abuse
Recommend enhancements to FADS that improve efficiency, data retrieval, interpretation, and presentation
Analyze, forecast, trend, and interpret complex healthcare data to support operational and business planning
Present analytical insights to stakeholders for decision making and strategic review
Experience in Medicare or private insurance program integrity will also be considered
Demonstrated expertise in healthcare data analysis and fraud detection methodologies
Excellent written, verbal, and presentation skills

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' experience in Medi Cal (Medicaid) and/or Managed Care, with a strong focus on program integrity
2 years' experience using BusinessObjects
Knowledge of Microsoft Office Suite

Preferred Qualifications:

Experience using Power BI, SQL, SAS and Power BI
Bachelor's degree in healthcare or a related field

Work Location:

Hybrid position: Currently one day per week on site in Sacramento, CA
Please note: The position is contractually designated as onsite, and in office requirements may increase up to daily attendance based on business needs

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.

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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.