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Senior Business Process Analyst - Eden Prairie, MN

UnitedHealth Group


Location:
Eden Prairie, MN
Date:
03/24/2017
Job Code:
1721536
Apply on the Company Site
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Job Details


Senior Business Process Analyst - Eden Prairie, MN(Job Number:702703)
Description

Be part of something daring and bold and help rewrite the history of UnitedHealth Group!

We're changing the landscape of health care with people like you, who really know how to get down to business. When you join us at UnitedHealth Group as a Business Analyst, you will use your sharp business skills to assist in creating, controlling and improving business processes. You will solve complex problems as you serve as a resource to others on your elite team. You will create process design, project implementation, diagnose process improvement opportunities and develop solutions. You will also provide quality reporting, analysis, audits, and develop plans and programs to support continuous quality improvement. You'll be in the driver's seat on vital projects that have strategic importance to our mission of helping people live healthier lives. You'll be doing
your life's best work.(sm)

Primary Responsibilities:

  • Filter production oversight –  inventory assignment, reporting, and quality assurance
  • Filter efficacy validation – monitor reporting to ensure that filters are properly excluding claims
  • Removal governance and confirmation – promote stakeholder adherence to governance process and participate in governance discussions; confirm that removals take place
  • Research of filter exceptions – investigate instances when claims stop despite exclusions; identify and work with exclusion fulfilment teams to address root cause
  • Process improvement – participate and help lead the filter redesign project; examples include: filter life cycle documentation, development of additional filter controls and validation mechanisms, automation, creation of a Master Exclusion List
  • Reporting development – create reporting to show impact of filter process, including individual filters, on FWAE pre payment value creation
  • Provide data - driven recommendations for exclusion adjustments

    • False positive reduction – identify proactive opportunities to remove providers from review
    • Reduce over-filtering – identify opportunities to reduce exclusions that are omitting aberrant claims from review

 


Job Business Process & TQM
Primary Location US-MN-Eden Prairie
Other Location 
Organization Optum Ops-Payment Integrity
Schedule Full-time
Number of Openings 1
Apply on the Company Site

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.

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