Website UnitedHealth Group

Position Description

We are looking for a professional in OGS, part of the UnitedHealth Group family of businesses, payment integrity – Value stream analytics teams. Our work area includes projects related to identify opportunities in Fraud Waste Abuse (FWAE)/Data Mining/Coordination of benefits and other ideation/POCs projects related to these areas.  We are a team of researchers, clinical SMEs and applied data scientists working on to identify aberrant patterns in healthcare claims data.

Candidate will be responsible for delivering various fraud waste abuse and error, DM, COB analytics projects based on US healthcare professional and facility claims data and other consulting assignment related to these areas. These projects may involve new algorithm development, existing algorithms enhancement /maintenance, validation and rule governance, or statistical model development. Lead and work closely with junior/senior analysts to deliver Fraud, Waste, Abuse (FWA) Projects in facility inpatient area.

Candidate will provide clinical support to management in business development, client proposals and in building strong relationships with global analytics teams.

Candidate should be an expert in data analytics with significant amount of project delivery skills in Fraud detection analytics, ideation, secondary research, data visualization in professional, and facility Space.

Primary Responsibilities:

  • Collaborate across business units with stakeholders, provide thought leadership, and drive day-to-day implementation of our analytics strategy
  • Provide explanations and interpretations within area of expertise by analyzing and investigating
  • Work to gather, examine, and analyze data; write technical specifications for manipulating data to look for Fraud, abuse and waste
  • Independent project handling, client communication and project documentation
  • Demonstrate a strong understanding of project scope, data extraction methodology, design of dependent and profile variables, logic and design of data cleaning, exploratory data analysis and statistical methods
  • Produce timely and error-free deliverables in an efficient manner, managing multiple tasks and varying project scopes
  • Maintain quality control and ensures the maintenance of proper project/report documentation
  • Communicate key analytic findings to client, and be responsible for addressing client’s analytic concerns
  • Communicate clearly and effectively both orally and in writing; conduct meetings and make professional presentations
  • Research on the new fraud and abuse patterns, opportunities and ideate new assignments/projects basis the secondary/data driven research
  • Organize and manage time and resources; establish priorities and coordinate work on many projects simultaneously
  • Coordinate with clinical/Coding SMEs for seeking the inputs to explore data extraction approach and road map the analysis mile stones
  • Develop and maintain working relationships with key customer stakeholders

Required Qualifications:

  • Coding credential COC/CPC-H; will also consider Registered Nurse with coding experience or BAMS/ BHMS/BPT
  • 12+ years of experience, with at least 7+ years of experience in Facility Inpatient/Outpatient coding and sound understanding of payment integrity – Fraud, Waste and Abuse, COB
  • Experience comprising analytics service delivery, solution design and client management
  • Experience in data analytics, strategy, project management, team management and business development
  • Sound working experience in SQL, SAS, SAS eMiner
  • Proficiency with professional and facility Inpatient/Outpatient coding (DRG/APC payment methodology) and Coding experience from paper charts as well as EMR
  • Knowledge of analytical tools and techniques, especially relating to data mining and analysis
  • Strong communication, interpersonal, and leadership ability across all levels coupled with effective problem solving, conceptual thinking, quantitative and analytical skills
  • Strong project management skills, ability to influence cross-functionally in a rapidly evolving business environment while managing multiple/concurrent projects
  • Ability to handle/work on large data sets
  • Ability to communicate ideas effectively and concisely to all levels of Management, business partners, and to other external clients
  • Ability to work independently and with a team
 

Preferred Qualifications:

  • Experience/interest in using analytical open source software like R/Python
  • Experience/interest in data visualization and presentation like Tableau, MS Power BI
  • Healthcare domain certifications (AHM)
 

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: Senior Data Analyst, Data Analysis, Clinical, Coding, Coder, COC, CPC, Registered Nurse, RN, BAMS, BHMS, BPT, Fraud, Waste and Abuse, COB, SQL, SAS, SAS eMiner, DRG, APC, EMR, Noida, Uttar Pradesh

Job Details

  • Contest Number841660
  • Job TitleSenior Data Analyst – Clinical – Noida, UP
  • Job FamilyAnalytics
  • Business SegmentOptum Operations

Job Location Information

  • Noida
    India
    Asia Pacific

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job Level
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionNo
  • Overtime StatusExempt

To apply for this job please visit careers.unitedhealthgroup.com.