Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that’s improving the lives of millions. Here, innovation isn’t about another gadget, it’s about making health care data available wherever and whenever people need it, safely and reliably. There’s no room for error. Join us and start doing your life’s best work.(sm)
This role performs analysis activities related to the Data Mining programs both prospective and retrospective which incorporates building data acquisition pipelines, data preparation and consolidation and developing analytics based on specified business requirements. Accurate and timely mapping, testing and analysis activities related to the Data Mining and CCM programs is also required to facilitate return on investment from the data pipelines built. The candidate will review all types of medical claim payments against claims platforms, Payment Integrity systems (HDTV, CCM) contract systems (NDB, CORE, Jetson, Emptoris) and auxiliary systems to prove out design and implement data pipelines and analytics.
Primary Responsibilities:
Develops automation and scraping utilities, analytics and data pipelines using a range of technologies
Documentation of backlog of use cases for each data asset
Coordinates with business owners to obtain access to data assets
Ability to translate business requirements and acumen to a technical audience
Data mapping, understanding and acquisition in advance of analytics
Scripting, stored procedures and scheduling
Production of test plans and scripts
Testing of new data pipelines and analysis to ensure data quality, integrity and alignment with customer specifications
Technical peer code review and provides recommendations for improvement
Periodic optimization and refactoring of recurring analytics
Solves complex problems and develops innovative data/technical solutions to serve the business
Serves as a key resource on complex and/or critical data issues
Maintenance of documentation related to Data Mining data assets
Supporting Data Mining transformation and growth activities, both complex and varied
Performs complex data and conceptual analyses
Design and production of business minimum viable product (MVP) in line with top priority use cases to accelerate consumption of data asset
Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
Required Qualifications:
Graduation degree in any stream
2 years of experience as SQL developer with proficient knowledge of SQL Server, Oracle and Teradata syntax
1+ years of experience working with processing and reviewing medical claims platforms with UHC environment with particular focus on E&I UNET
Experience in SSIS maintenance and migration projects
Experience working with large data sets/systems/warehouses to translate data into information for decision making
Experience in requirement analysis, data mapping, design, development and testing of data assets
Experience reading and interpreting provider contracts, fee schedules, and claim payment policies
Experience analyzing large data sets to determine trends / patterns
Expertise debugging capabilities and resolving the issues while executing the code and automate processes
Healthcare Industry knowledge (Commercial contract audits, prepay review, processes)
Intermediate level of proficiency working with Microsoft Excel including formulas, calculations, charts, graphs, etc.
Understanding of UHG data sources, specifically UNET, NDB, CORE (claim, payment integrity, contract and member systems)
Excellent technical skills (SQL, python, SSIS)
Strong programming skills
Good communication skills with the ability to communicate complex information effectively
Identification of use cases and validation of concepts
Excellent relationship management
Effective communication skills
Ability to handle multiple priorities and deadlines effectively and efficiently
Ability to overlay claim SME knowledge to technical deliverables
Preferred Qualifications:
2+ years of experience using at least one of the following claims platforms: NICE, Facets, or Cosmos
Experience with API integration
Python, HIVEQL or Spark
PowerBI
Careers with Optum. Here’s the idea. We built an entire organization around one giant objective; make the health system 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)
Job Keywords: Associate Data Analyst, Hyderabad, TG, Telangana
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