Sr Data Analyst - 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.

This is an exciting role in the growing Optum Health division within UnitedHealth Group. This role will report into our analytics leaders out of Dublin, Ireland but will operate as a conduit between our Ireland Data Science group and will have primary responsibilities to support our US stakeholders. The ideal candidate is passionate about working with data and driven to deliver creative and compelling solutions and analytic results which turn data into actionable insights for our business. The prospective Senior Data Analyst will support the organization in identifying key trend components of the Optum Health clinical programs, key metrics for clinician documentation needs, statistical sampling, gap analysis, and assure data quality.

Positions in this function are responsible for the management and manipulation of mostly structured data, with a focus on building business intelligence tools, conducting analysis to distinguish patterns and recognize trends, performing normalization operations and assuring data quality. Team members will typically use business intelligence, data visualization, query, analytic and statistical software to build solutions, perform analysis and interpret data. Positions in this function work on predominately descriptive and regression-based analytics and tend to leverage subject matter expert views in the design of their analytics and algorithms.

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

Primary Responsibilities:

• Stratify clinical documentation systems to identify sampling size needs and ensure coding accuracy. Develop process controls and reconciliation for file transfers and data processes.
• Create analytics to support documentation completeness and data-driven decisions for outcomes. Merge and scrub data from different sources to highlight clinical outcomes and program impact
• Use business intelligence, data visualization, query, analytic, and statistical software to build solutions, perform analysis, and interpret data. Write and understand SQL/SAS queries for in-depth statistical analysis and interpretation
• Ensure accurate data submission to regulatory entities like CMS for risk adjustable populations. Optimize data submission for Hierarchical Condition Categories (HCCs) and Quality performance using available tools and risk models
• Collaborate with internal and external partners to minimize submission errors and report pertinent data sets. Develop and improve processes related to risk adjustment and quality improvement, ensuring compliance with laws and regulations
• Recommend and guide process improvements to optimize risk adjustment factors and minimize inaccurate disease burden capture. Identify, analyze, interpret, and communicate risk adjustment trends to provider partners and related entities
• Develop and maintain reporting capabilities to measure and forecast risk scores and quality metrics and identify areas of improvement. Maximize risk adjustment revenue and quality bonus payments through data integration and analytics
• Validate data integrity and collaborate with technical teams to improve data pipelines and business logic. Lead internal subject matter experts in meetings to rectify data submission and adjudication errors
• Develop and maintain data sets leveraging internal and regulatory response data for enterprise use. Demonstrate mastery in running applicable risk models for Medicare Advantage and Commercial ACA members
• Assist with audits, including RADV, through preparation and documentation, performing root cause analysis to maintain high data integrity. Stay updated on CMS regulations and announcements affecting risk adjustment and CMS Star Ratings
• Prepare and review specifications, project plans, and procedural documents, providing regular status updates to supervisors and stakeholders. Support projections for annual receivables, pricing efforts, and cost utilization related to risk adjustment
• Coordinate data releases and modifications through approved procedures. Collaborate with internal teams, provider partners, and vendors to support risk adjustment activities

Job Scope:

• Anticipates customer needs and proactively develops solutions to meet them
• Serves as a key resource on complex and/or critical issues
• Solves complex problems and develops innovative solutions
• Performs complex conceptual analyses
• Reviews work performed by others and provides recommendations for improvement
• Forecasts and plans resource requirements
• Authorizes deviations from standards
• May lead functional or segment teams or projects
• Provides explanations and information to others on the most complex issues
• Motivates and inspires other team members
• Develops innovative approaches
• Sought out as an expert

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:

• 5+ years of working knowledge of relational databases, database structures (SQL, Oracle, Teradata)
• 3+ years of experience developing in business intelligence/visualization software (preferably Tableau or Power BI)
• 3+ years of healthcare industry or related claims experience
• Demonstrated intermediate level of proficiency developing SAS/SQL queries
• Demonstrated intermediate level of proficiency with MS Office Suite (Excel, Access, PowerPoint, Word)
• Proven excellent critical thinking and problem-solving skills
• Proven excellent oral and written communication skills

Preferred Qualifications:

• Healthcare risk adjustment experience
• Patient clinical management data experience

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

The salary range for this role is $89,800 to $176,700 annually based on full-time employment. 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 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.