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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 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. By delivering solutions across spectrums of health care, Optum is focused on our aspiration of improving experiences and outcomes for everyone we serve while reducing the total cost of care. In support of this, OptumInsight's purpose is to connect the health care system with trusted services, analytics, and platforms that make clinical and administrative processes valuable, easy, and efficient for everyone. OptumInsight provides analytics, research, consulting, technology, and managed services solutions to hospitals, physicians, health plans, government agencies, life science companies, and other industry partners. In addition to our many commercial clients, OptumInsight capabilities and technologies are leveraged by OptumHealth, OptumRx, and our sister company UnitedHealthcare. This position will be responsible for scoping, analysis, and delivery of analytics-oriented projects. Qualified candidates will possess a solid understanding of reimbursement methodologies and concepts that include APC, DRG, Per Diem, RBRVS, etc. Candidates should also have experience working with large medical claims datasets and be familiar with how to quickly identify issues with claims data quality. Candidate should be able to work independently and collaboratively in a matrixed team environment and possess solid problem-solving skills. You’ll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** - Assist in the maintenance and support of the Normalized Pricing product. - Perform product releases and updates and collaborate with different teams to synchronize the algorithm across various platforms. - Provide support to customers, including supporting product implementation and consultation, making recommendations, performing pricing, analyzing and explaining results, identifying issues, and providing solutions. - Process client submitted claims via a SQL application and then analyze the results. - Function as a hybrid analyst supporting the development of spreadsheet models (about 25% of the time). - Work with clients to explain analysis results and coordinate data requests and submissions with clients. - Process data according to project specifications either individually or through collaboration with other consulting subject matter experts. - Organize and communicate results to customers in the form of reports and/or presentations. - Engage in the maintenance of existing and development of new products and solutions to enhance revenue growth opportunities. - Work directly with customers throughout the implementation process for standalone clients. - May require on occasion working nights and weekends for client support and/or production releases. 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:** - 4+ years of solid SQL experience, preferably in T-SQL and MS SQL Server environment with knowledge of database maintenance, ETL, and experience with complex scripts. - 3+ years of experience working with and analyzing health care data. Must be familiar with claim structure, data components, and relationships that contribute to reimbursement. - 1+ years of experience with CMS Prospective Payment frameworks and/or reimbursement methodologies including DRG, APC, RBRVS, Per Diem, etc. **Preferred Qualifications:** - Experience with SAS. - Proven solid communication skills and attention to detail. Must have the ability to communicate effectively to all audiences (technical to senior leadership). - Proven excellent data quality assessment skills. Must be able to leverage knowledge of UB and CMS claims to quickly identify problems within a submitted claims dataset. - Proven excellent data analysis skills, presentation skills, and a demonstrated ability to assess patterns, trends, and behaviors within large health care claims populations. - Demonstrated intermediate to advanced proficiency level of skill in Excel. Knowledge of VBA, data connections, macros, pivot tables, and functions. - Experience in Python, Apache Spark, Cloud Computing. *All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy. **California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only:** The salary range for this role is $88,000 to $173,200 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives. **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 the 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. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. **Brand:** OptumInsight **Job ID:** 2231353 **Employment Type:** Full-time **Job Area:** Consulting **Posted Date:** 19/06/2024 Remote working/work at home options are available for this role. #J-18808-Ljbffr