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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Functions may include database architecture, engineering, design, optimization, security, and administration; as well as data modeling, big data development, Extract, Transform, and Load (ETL) development, storage engineering, data warehousing, data provisioning and other similar roles. Responsibilities may include Platform-as-a-Service and Cloud solution with a focus on data stores and associated eco systems. Duties may include management of design services, providing sizing and configuration assistance, ensuring strict data quality, and performing needs assessments. Analyzes current business practices, processes and procedures as well as identifying future business opportunities for leveraging data storage and retrieval system capabilities. Manages relationships with software and hardware vendors to understand the potential architectural impact of different vendor strategies and data acquisition. May design schemas, write SQL or other data markup scripting and helps to support development of Analytics and Applications that build on top of data. Selects, develops and evaluates personnel to ensure the efficient operation of the function.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities:

• Data Conversion & Migration
  • Extract and transform legacy TRACS bill plan data into MEP enrollment format.
  • Translate legacy member IDs, product codes, and dual status indicators.
  • Load transformed data into MEP transaction tables
• Billing Transaction Generation
  • Generate monthly prospective billing based on active bill plans and dual status.
  • Generate annual retrospective billing to reconcile and “true up” prior transactions
  • Apply logic to determine billing eligibility and calculate billing durations (e.g., DEA = 24 months, Recert = 12 months)
• Overlap Management
  • Identify and remediate overlaps between legacy and MEP-generated enrollments
  • Develop scripts to manage retention enrollments and prevent duplicate billing
• Reporting & Evidence Migration
  • Migrate transaction records and evidence from TRACS to MEP for reporting and trending.
  • Identify and move necessary tables for future reporting needs
• Operational Coordination
  • Collaborate with MMS, Data Platform, and PeopleSoft teams to ensure billing continuity.
  • Support transition planning and execution as TRACS sunsets in January 2026

General Profile:

• Company thought leader
• Functional SME
• Broad business approach
• Resource to senior leadership
• Develops pioneering approaches to emerging industry trends

Job Scope:

• Predicts emerging customer needs and develops innovative solutions to meet them
• Solves unique and complex problems with broad impact on the business
• Participates in the development of business strategy
• Develops and manages business plans to achieve objectives
• Leads large, complex projects to achieve key business objectives
• Translates highly complex concepts in ways that can be understood by a variety of audiences
• Influences senior leadership to adopt new ideas, products, and/or approaches
• May have segment-wide impact
• Directs cross-functional and/or cross-segment teams

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 experience with billing systems (TRACS, MEP, PeopleSoft)
• Knowledge of Medicare Advantage operations and billing adjustments
• Understanding of healthcare billing models (PMPM, enrollment fees)
• Familiarity with CMS monthly files (MMR) and dual status logic
• Proficiency in SQL/Azure and data transformation scripting
• Proven solid attention to detail in transaction validation and reconciliation
• Proven ability to interpret and apply complex billing rules and contract terms
• Proven ability to work cross-functionally with technical and operational teams
• Clear documentation and reporting of billing logic and outcomes

*All employees working remotely 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 $132,200 to $226,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.