Sign In
 [New User? Sign Up]
Mobile Version

Risk Adjustment Business Analyst - Special Projects - Telecommute

UnitedHealth Group

Eden Prairie, MN
Job Code:
Apply on the Company Site
  • Save Ad
  • Email Friend
  • Print
  • Research Salary

Job Details

739896 Risk Adjustment Business Analyst Special Projects Telecommute

Risk Adjustment Business Analyst - Special Projects - Telecommute (739896)

Position Description

If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm)

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

The Risk Adjustment Business Analyst- Special Projects is responsible for managing and overseeing the end-to-end execution of Retrospective services and projects within the Risk, Quality and Network Services (RQNS) segment and providing primary support to Claims Verification RQNS SMEs. The Business Analyst will interact with multiple levels of matrixed staff and functions / departments across one or more business units. The Business Analyst will develop and implement service enhancements to services as required and will work across multiple operational teams to ensure proper establishment of services and operational excellence. The Business Analyst will provide leadership to manage service definitions, requirements creation, operational and technical considerations,  and operational effectiveness oversight to ensure proper execution of services.  Further, this individual will solve for complex business issues and represent the concerns of RQNS and the client in escalated management, legal, compliance and client satisfaction issues. The Business Analyst will be responsible for supporting forecasting and trending analyses as appropriate for all assigned services.

Primary Responsibilities:
  • Leads requirements gathering meetings, prepares meeting notes and requirements documentation, meets with TE to review business requirements and system design, and performs user acceptance testing
  • Serves as a SME or works with Operations SMEs for one or more areas of  business operations and/or products for requirements gathering, design, and testing
  • Performs some project management functions - coordinates meetings, manages tasks to timeline
  • Researches CMS documentation, coordinates answering project questions from internal team and clients
  • Conducts and manages outcomes of various studies that include analyzing, reviewing, forecasting, trending, and presenting information for operational and business planning
  • Supports short and long term operational / strategic business activities by developing, enhancing and maintaining operational information and models
  • Develops and implements effective / strategic business solutions through research and analysis of data and business processes 
  • Oversee and manage ad-hoc client requests for assigned services
  • Performs technical reporting and reconciliation by using existing reports and SQL queries to identify, manage and reconcile inventory
Required Qualifications: 
  • 3 or more years of experience working with health care operations
  • 2 or more years of experience in Risk Adjustment and HCC models for Medicare and ACA
  • Experience gathering requirements from the client / business and documenting
  • Intermediate proficiency with SQL  
  • Working knowledge of relational databases, database structures
  • Support short and long term operational / strategic business activities through analysis
  • Travel up to 10%
Preferred Qualifications:
  • Undergraduate degree in Business, Finance or a related field
  • 3 or more years of process analysis experience
  • 3 or more years of data analysis experience
  • 2 or more years understanding Medicare (or Affordable Care Act) risk adjustment principles and concepts
Soft Skills:
  • Ability to communicate analysis including trends and opportunities to clients and the business in writing and verbally
  • Ability to problem solve including multiple priorities and research conflicting and/or inaccurate data

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)


*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.


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.   


Job Keywords:  Risk Adjustment Business Analyst, Special Projects, Telecommute, Remote, Work from Home

Job Details

  • Contest Number739896
  • Job TitleRisk Adjustment Business Analyst - Special Projects - Telecommute
  • Job FamilyBusiness Operations
  • Business SegmentOptumInsight

Job Location Information

  • Eden Prairie, MN
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelManager
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionYes
  • Overtime StatusExempt

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

Powered ByLogo

Featured Jobs[ View All ]

Featured Employers [ View All ]