Data Analyst - Fraud Waste And Abuse - Remote

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.

Optum Program Integrity (PI) Analytics is a suite of complementary, web-based components that mine provider, member, and claims data for potential fraud, waste, and Abuse; provide software research tools; and track subsequent investigation activity. The PI team is comprised of individuals with a variety of technical expertise from database, business intelligence reporting, and web-based tools.

This role will support one or more state government clients. The PI team is looking for a solid data-focused analyst able to quickly develop a comprehensive understanding of fraud, waste, and Abuse detection software. The analyst should have the ability to collaborate with multiple roles, including fellow business analysts, data engineers, software engineers, and report developers. This individual will be involved in many phases of an implementation and/or operational project(s). This individual will become familiar with and may refine the database structures, testing software, documentation procedures, and training and User Manual formats. This role will be key in the successful implementation of new projects and in the maintenance of existing projects.

Primary Responsibilities:

• Research and analyze data for fraud, waste, and Abuse scenarios
• Work independently, take initiative, and handle multiple tasks simultaneously
• Write clear, concise, and extensive user documentation using advanced features of MS Word
• Use advanced features of MS Excel, such standard deviation, formulas, and other functions
• Write test cases and execute testing within a web service environment
• Plan, document, evaluate, and track testing results to ensure analytics are free from defects
• Establish and maintain test cases and test data, includes an intermediate knowledge of SQL
• Actively participate in walk-through, inspection, and peer reviews for quality assurance of deliverables
• Participate in production implementation verification and be accountable for validating the quality of all analytics
• Support development of downstream deliverables, such as summary reports and presentations for client(s)
• Communicate and interact with appropriate areas on problems, changes, and enhancements that may impact data, workflow, and/or functionality
• Share knowledge (train) other team members and business users on any of the skills listed above

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:

• 2+ years of experience with fraud, waste, and Abuse analysis experience
• 2+ years of SQL developing queries and joins
• 2+ years of experience with data analysis experience and working with database structures
• 1+ years of experience with healthcare claims, medical terminology, medical diagnostic, and procedural terms
• Proven intermediate to advanced computer skills consisting of Microsoft Excel, Outlook, Word, and Power Point

Preferred Qualifications:

• Certified Professional Coder (CPC)
• Knowledge of Medicaid policies and data (claims, provider & member)
• Experience with any of the following tools: CA Agile, Aha!, DevSuite, HP-ALM, Benthic Golden

• All employees working remotely will be required to adhere to 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: 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.