UnitedHealth Group Senior Claims Configuration Analyst - Employer & Individual - Telecommute in Eden Prairie, Minnesota
We have an opportunity for a Senior Configuration Analyst with experience in building and configuring claims within a new business configurable system (similar to Facets, HealthRules or QNXT). In this role you will design, build, and validate across functional areas, for adjudication schedules, provider certification and accreditation, remark and deny reason codes, claim audits, delegation and prompt pay and more. You will support complex system configuration changes and new configuration requirements, including configuration analysis, design, build and testing. Duties include troubleshooting and fixing system configuration errors, performing investigations and root cause analysis of trouble tickets, and ensuring day to day issues are identified and appropriately addressed.
This role is office based in Eden Prairie, MN. The role is available to telecommuters who
This role is office based in Eden Prairie, MN. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges if you are willing and able to travel to Minnesota, 25% of the time, for meetings and training.
Analyze products, contracts and pricing, design/configure claim rules and clinical rules, conduct configuration validation, and perform configuration peer review
Communicate design to all stakeholders at varying levels of the organization
Present and evaluate design solutions objectively and facilitate conflict resolution
Define, use and communicate design patterns and best practices in service-oriented analysis, design and development
Configuration Build & Maintenance
Configure new business, including products / benefits, clinical, claims and/or capitation, within a health plan configuration system (e.g. Facets)
Update source-to-target data mapping and/or data transformation rules
Configuration Quality Assurance
Participate in quality assurance and testing within health plan configuration system (e.g. Facets) to ensure configuration is ready for implementation
Collaborate with quality assurance team to ensure testing efforts align with system deliveries and business processes
Recommend strategies to improve service development life cycle and governance processes
Understand and use enterprise service and data models
Bachelor’s degree or equivalent experience
3+ years of Benefit, Claim and/or Enrollment configuration experience
3+ years of healthcare and/or health insurance experience
3+ years of experience identifying patterns within quantitative data, drawing conclusions and recommending solutions and approaches; skilled with end-to-end issue resolution
Intermediate or greater level of proficiency with Microsoft Excel and Word
Product, Benefit, Claim and/or clinical research and analysis knowledge
Large-scale platform implementation or migration experience
Knowledge of data structures within a health plan configuration system (e.g. Facets)
Ability to clearly articulate (both verbal and written) project status and issues management
Excellent oral and written communication skills, interpersonal skills and organizational abilities are essential
Ability to work effectively with minor supervision
Ability to manage multiple assignments while maintaining quality standards and meeting assigned deadlines
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work. SM
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: Configuration Analyst, Minnetonka, MN, Minnesota