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Associate Quality Analyst

$60.2k - $107.4k

Reliant Medical Group

Data Analyst

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.

The Data Analyst role requires a highly flexible and adaptable candidate with the ability to handle periods of stress and/or heavy workloads. The ability to adeptly navigate ever changing priorities is also a key skill of the Data Analyst position. The Data Analyst primarily works independently, however, is also expected to work collaboratively across teams and the organization to support our client's needs and meet their affordability goals.

Job responsibilities include performing Integrated System Testing activities. Develop claim scenarios to test CES facility and physician edits, as well as maintain the existing test suite of claims.

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

Primary Responsibilities:

  • Develop and implement effective physician and/or facility claim scenarios that test updates and change initiatives for all standard, customized, and repricing templates
  • Maintain a robust test suite of physician and facility claims for effective and efficient testing of edits for all lines of business
  • Collaborate with internal and external business partners to identify and remediate defects within edits
  • Actively participate in cross-team meetings to support the client's requests
  • Apply Quality Assurance audit results for future integration and system development and testing
  • Identify process improvement opportunities and actively participate in process improvement teams
  • Ensure completion of assigned tasks by posted deadlines
  • Participate in new hire training and work with mentors
  • Support post deployment validation
  • Comply with the Software Development Lifecycle (SDLC) and agile Methodologies
  • Understand Testing, Stage and production environment concepts
  • Establish the right strategies for Test Data
  • Adhere to compliance checks, e.g., HIPPA, Quality control guidelines and practices

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • High School Diploma/GED
  • 2+ years of claims processing experience or equivalent knowledge
  • 1+ years of reimbursement policy experience

Preferred Qualifications:

  • 5+ years of healthcare reimbursement experience
  • 6+ months of specific CES claim editing experience
  • 2+ years of user acceptance testing experience
  • Strong analytic, technical, and problem-solving skills
  • CPC or other coding certification

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

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO #GREEN

Vacancy posted 4 days ago
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