Job Description
Optum is a global organisation 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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. About the Role: At UnitedHealth Group and Optum, we want to make healthcare work better for everyone. This depends on hiring the best and brightest. With a thriving ecosystem of investment and innovation, our business in Ireland is constantly growing to support the healthcare needs of the future. Our teams are at the forefront of building and adapting the latest technologies to propel healthcare forward in a way that better serves everyone. With our hands at work across all aspects of health, we use the most advanced development tools, AI, data science and innovative approaches to make the healthcare system work better for everyone. The Senior Business Analyst is part of the Submissions & Supplemental Data team nested in the Clinical Solutions Data Ops workstream responsible for driving global execution of scaled data processes required to deliver the risk adjustment and quality services. Within this broader team, the key accountability for the Senior Business Analyst will be reporting development, maintenance and distribution to serve both the needs of external clients, as well as internal operations. Careers with Optum offer flexible work arrangements and individuals who live and work in the Republic of Ireland will have the opportunity to split their monthly work hours between our Dublin or Letterkenny office and telecommuting from a home-based office in a hybrid work model. Primary Responsibilities of the Senior Business Analyst: Track Claims Verification Inventory within the MRM Application and ensure Claims are being evaluated against chart coding results timely. Identify (query the data in multiple systems), log and address any aging inventory and bottlenecks in the E2E Claims Verification process with our operational partners and application support. Track Claims Verification Data Delivery results from OptumInsight's MRM Applications through to the client and remediate failed or excluded inventory in downstream system processing. Perform End-To-End reconciliation reporting of Claims Verification results to identify what records were delivered to the client and when to ensure we are in compliance with all Federal Regulatory requirements. Participate in Operational Readiness tasks such as reviewing and approving client specific configurations, establishing processing timelines, validating required data and data feeds, and implementing client project specific controls. Provide weekly reports to Account Management and Analytics for contracted clients, indicating project status and expected results. Assist with Revenue Projections for the Claims Verification service in partnership with Chart Operations on a quarterly basis to Finance. Assist with maintenance of SOP documentation, process documentation, reporting controls, presentation materials and the CV SharePoint site to ensure we are meeting all UHG's audit requirements. In collaboration with Application Support and Product, improve end-to-end processing issues, address ongoing bottlenecks and test any implemented changes prior to release to production environments for these identified issues. Required Qualifications of the Senior Business Analyst: Ability to independently review and understand Oracle Database architecture in order to perform analysis against claims data as it moves through multiple operational processes across multiple data stores. Ability to write advanced SQL queries in Oracle/PSQL for purposes of identifying and reporting out operational issues to the Application Support team for remediation. Ability to create reports in Excel and Tableau against existing data stores for purposes of reporting status and results to Operational Leadership, Account Management and/or Compliance. Preferred Qualifications of the Senior Business Analyst: Basic understanding of Claims Data and 837P and 837I transaction requirements. Ability to evaluate operational results in response to Client inquiries regarding contracted services. Ability to juggle multiple tasks with grace and calm under very tight timelines. Ability to work collaboratively in a highly matrixed environment where role definitions can be murky. Ability to work independently and proactively and ask for help and knowledge transfer when needed. Ability to problem-solve operational issues "on the fly" without significant direction or oversight. Please note you must currently be eligible to work and remain indefinitely without any restrictions in the country to which you are making an application. Proof will be required to support your application. All telecommuters will be required to adhere to the UnitedHealth Group’s Telecommuter Policy. 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. Diversity creates a healthier atmosphere: Optum is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to gender, civil status, family status, sexual orientation, disability, religion, age, race, and membership of the Traveller community, or any other characteristic protected by law. Optum is a drug-free workplace. 2023 Optum Services (Ireland) Limited. 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