About the Position

Pursue your passion and potential

Recovery Resolution Consultant

Dallas, Texas + Additional locations

This position is National Remote. You'll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.

About the Role

In healthcare, evolution doesn't just happen. It takes innovation, imagination, and a passion for solving problems in new and better ways. And innovation is taking place at a lightning-fast pace every day at Optum.

As the fastest growing part of the UnitedHealth Group family of businesses, we're expanding our team and creating excellent opportunities for those who want greater purpose and more impact in their work. We'll provide investment, support, and resources to advance your career. You'll provide the talent, ambition, and drive.

Join our Competitive Intelligence team, part of the Ideation and Growth group, where we focus on uncovering market trends in payment integrity and medical spending to drive new business and cost-saving opportunities. As a Business Analyst, you'll collaborate with exploratory auditors and data analysts to transform early-stage concepts into scalable, data-driven solutions. This role involves conducting investigative research, and performing targeted data analysis to assess the viability of new initiatives.

Responsibilities

• Conduct root cause analysis for insourcing concepts including research / verification of identified claims
• Performs complex data and conceptual analyses
• Project delivery
• Requirements documents including user stories / BRDs
• Testing and quality management including production of test plans and scripts
• Ability to translate business requirements and acumen to a technical audience
• Operational readiness including preparation of operational documentation and training
• Serves as a key resource on complex and / or critical data issues
• Supporting cross value stream transformation and growth activities, both complex and varied

Requirements

Required Qualifications

• High School Diploma / GED
• Must be 18 years of age OR older
• 3+ years of experience with researching medical claims, including provider contract, claim payment policies and regulatory review
• 3+ years of hands-on experience with reviewing and pricing E&I UNET claims
• Experience with analyzing large data sets to determine trends / patterns
• Experience with project delivery and execution
• Ability to work any shift between the hours of 8:00 am - 5:00 pm EST from Monday - Friday

Preferred Qualifications

• Experience with analyzing business processes and workflows, providing evaluations, benchmarks, and process improvement recommendations
• Experience in KPI management and reporting
• Experience with using SQL and Microsoft Excel
• Experience with using CDB, iBaaG, iCUE, Doc360 / Emptoris, ODAR, Claim Miner, COW

We Offer

• Competitive salary range from $72,800 - $130,000 annually based on full-time employment
• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements)

About the Company

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.