CCM Business Data Analyst – Dublin/Letterkenny

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 makes 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.

At UnitedHealth Group and Optum, we want to make healthcare work better for everyone. This depends on hiring the best and brightest. With a thriving ecosystem of investment and innovation, our business in Ireland is constantly growing to support the healthcare needs of the future.

Our teams are at the forefront of building and adapting the latest technologies to propel healthcare forward in a way that better serves everyone. With our hands at work across all aspects of health, we use the most advanced development tools, AI, data science and innovative approaches to make the healthcare system work better for everyone.

As the CCM Business Data Analyst, you will join a dynamic analytics team focused on identifying overpayments in healthcare professional and institutional claims across all UnitedHealthcare lines of business. This role involves developing and maintaining non-clinical analytics, leveraging domain expertise and advanced data mining techniques to uncover insights, drive innovation, and optimize algorithms. You’ll collaborate closely with global analytics teams and business stakeholders to deliver impactful solutions.

Primary Responsibilities of the CCM Business Data Analyst:

• Research and analyze potential overpayment scenarios using client policies and provider contracts to build recurring analytics.

• Identify patterns and anomalies in claim payments through big data analysis.

• Collaborate with stakeholders to gather and validate business requirements, ensuring specifications are complete, consistent, and actionable.

• Develop and refine analytic logic to ensure accurate claim payments.

• Communicate key findings to clients and address analytic concerns effectively.

• Manage multiple projects simultaneously, prioritizing tasks and resources efficiently.

• Write technical specifications for data manipulation and trend analysis.

• Apply strong understanding of project scope, data extraction, variable design, data cleaning, and exploratory analysis.

• Consult with business stakeholders and subject matter experts to incorporate relevant medical and business content into analytic strategies.

• Partner with Business Analysts and Domain SMEs to define reporting requirements.

• Deliver scalable, automation-ready analytic solutions for payer and provider markets.
  

You will be rewarded and recognised 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 providing development for other roles you may be interested in.

Required Qualifications of the CCM Business Data Analyst:

• Bachelor’s degree or higher in Information Technology, Healthcare, Clinical Research, or a related field

• Proven previous experience in data analytics and healthcare claims processes

• Deep understanding of U.S. healthcare systems, payment integrity, and the claims lifecycle (including adjudication and pre-adjudication)

• Familiarity with Optum internal applications such as UNET (PCOMM), ISET, and COSMOS (M&R)

• Knowledge of E&I or M&R claims processing

• Proficiency in Microsoft Excel, Access, PowerPoint; working knowledge of SQL or SAS

• Proven ability to detect data anomalies and conduct root cause analysis in healthcare claims

Preferred Qualifications of the CCM Business Data Analyst:

• Medical coding or clinical certification (e.g., CPC, CPC-H)

• Experience with Agile/Scrum methodologies

Soft Skills of the CCM Business Data Analyst:

• Strong project management skills with the ability to influence cross-functional teams in a fast-paced environment

• Excellent written and verbal communication skills

• Strong analytical thinking, problem-solving, and attention to detail

• Ability to work independently and manage multiple priorities.

Please note you must currently be eligible to work and remain indefinitely without any restrictions in the country to which you are making an application. Proof will be required to support your application.

All telecommuters will be required to adhere to the UnitedHealth Group’s Telecommuter Policy.

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 marginalised 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: Optum is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to gender, civil status, family status, sexual orientation, disability, religion, age, race, and membership of the Traveller community, or any other characteristic protected by law. Optum is a drug-free workplace. © 2024 Optum Services (Ireland) Limited. All rights reserved.

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