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.
Primary Responsibilities
Gather, document, and analyze business and system requirements
Translate business needs into functional specifications, user stories, and system designs
Conduct impact assessments for system enhancements, integrations, and regulatory changes
Create process flows, data mappings, interface specifications, and business requirement documents
Collaborate with business users, architects, developers, QA teams, and product owners to deliver healthcare solutions
Support system implementations, upgrades, and modernization initiatives
Perform root cause analysis and troubleshoot production issues
Validate system functionality through testing, UAT support, and defect triage
Analyze healthcare data and workflows to identify process improvement opportunities
Support system integration initiatives involving healthcare applications and third-party platforms
Ensure compliance with healthcare regulations, policies, and organizational standards
Participate in Agile ceremonies including sprint planning, backlog refinement, and retrospectives
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
Bachelor's degree in computer science, Information Systems, Healthcare Administration, Engineering, or related fields
4+ years of experience as a System Analyst, Business Analyst, or Technical Analyst
Experience in US Healthcare domains, including Health Insurance / Payer, Provider Operations, Population Health, Care Management, Claims Processing, Revenue Cycle Management etc
Solid experience in requirements gathering and documentation, Ability to create BRDs, FR, User Stories, Process Flows, Data Mapping Documents
Traceability Matrices experience
Experience with Agile/Scrum methodologies and tools such as JIRA, Rally, or Azure DevOps
Good hands-on experience in tools like Tools - JIRA,Azure DevOps,Rally,Visio,Power BI and Microsoft Office Suite
Experience with cloud platforms such as Azure or AWS
Experience supporting digital transformation or cloud migration programs
AI/ML or Generative AI exposure in healthcare workflows
Healthcare Domain Knowledge is must with good Experience in payer business functions like Claims Adjudication, Benefits Configuration, Provider Management, Membership Administration, EDI Transactions, Care Management etc.
Solid understanding of Healthcare Standards- HIPAA,ICD-10,CPT,HCPCS,HL7,FHIR,X12 EDI (837, 834, 835, 270/271)
Knowledge of healthcare analytics and automation
Proven solid SQL skills for data analysis and troubleshooting
Proven excellent communication and stakeholder management skills
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.
Job description provided by UnitedHealth Group.
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