Senior Compliance Analyst for Flag Management

Senior Compliance Analyst For Flag ManagementAt 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 equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Senior Compliance Analyst for Flag Management is responsible for supporting provider-focused Fraud, Waste, and Abuse (FWA) pre-payment claim reviews, overseeing flag placement, and monitoring active flags. This role requires strong analytical skills, process design expertise, and cross-functional collaboration to ensure accuracy and efficiency in flag management and governance. The ideal candidate will demonstrate:A solid understanding of FWA, pre-payment claim processes and claims payment workflowsSolid communication skills, with the ability to convey information clearly and effectively in both written and verbal formatsProven ability to thrive in a fast-paced environment, managing multiple priorities while maintaining exceptional attention to detailYou'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:Serve as the subject matter expert for flag management processesAnalyze flag data and provide escalation support for flag and platform-related issuesLead complex flag initiatives and implement process improvements, incorporating updates into policies and job aidsMaintain accurate and up-to-date flag information in the tracking systemDesign and implement solutions to address gaps in flagged provider workflows and appealsCommunicate effectively with internal teams and external stakeholders through clear written and verbal communicationCollaborate with business areas to enhance claim system functionality and strengthen governance processesFacilitate governance meetings to promote alignment and process efficiencyBuild and maintain strong cross-functional relationshipsManage multiple projects and deadlines with effective prioritizationRequired Qualifications:High school diploma or GEDProficiency in Microsoft Excel and Word, or equivalent experience (5+ years)2+ years of experience in claims processing, healthcare, or regulatory-related rolesExperience with pre-payment flag processes, claims review or specialized training or experience in Fraud, Waste, and Abuse (FWA) investigationsDemonstrated ability to solve problems independentlyPreferred Qualification:Knowledge of healthcare policies, procedures, and documentation standards, or equivalent experience (5+ years)Practical experience working with claims platformsProven solid project management, organizational, and analytical skillsPay 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 $71,200 to $127,200 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 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.