The Sr. Business Systems Analyst will create and deliver high quality system solutions for our applications, products and services across all technology functions. They will consult with users and technology specialists to define business processes and the information systems for supporting those processes. They may perform analysis and also serve as business liaisons to understand and refine business requirements. They will provide technical support in developing systems that are cost effective and meet users' requirements. This function works to create systems that work together in a cohesive manner, enforcing standards and methods consistently across the enterprise. Roles may support both current system improvements and maintenance along with new system development.
You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Gather, analyze and document business requirements, and develop supporting materials such as use cases, flowcharts, models, specifications, and reports
Liaison with customers, users, and team to foster collaboration and consensus
Provide recommendations for improving system capabilities and performance to enhance value for end users
Follow approved procedures and templates, and implement process improvements
Champion the needs of the users throughout the software development life cycle
Collaborate with QA analysts to elaborate and validate test cases
Support the service/help desk in responding to technical and data questions that are received from end users, and support the users directly when necessary
Maintain and report on various project metrics as required
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.
Bachelor's degree or 7 + years equivalent work experience as a Business Systems Analyst
7+ years of experience in leading requirements capture, management and analysis activities, including conducting user interviews, leading and facilitating JAD sessions, and developing business process models and formal specifications
3+ years of experience with Business Intelligence tools
3+ years of experience with SQL data queries
Thorough understanding of claims and healthcare terminology and codes as published by CPT, ICD, HCPCS, and DRG manuals
Excellent analytical skills, the ability to integrate information from multiple sources to execute effectively and efficiently in a dynamic environment
Must have excellent verbal and written communication skills, ability to work independently with minimal supervision, be a team player, and be well organized and efficient with excellent judgment, problem-solving and decision-making skills
Bachelor's degree in healthcare, computer science, or business administration
5+ years of experience analyzing, processing or adjudicating medical claims data
Experience with Medicare Administrative Contractor (MAC) systems, Recovery Audit Contractor (RAC) systems, Centers of Medicare and Medicaid Services (CMS) Integrated Data Repository, and CMS fraud detection and prevention solutions
Knowledge of the Medicare FFS claims processing systems and business procedures
Past experience as a Unified Program Integrity Contractor (UPIC), or Medicare Drug Integrity Contractor (MEDIC) highly desirable
Experience in developing requirements for portals and content management systems
Experience working in an Agile and/or CMMI SDLC
Experience with AWS Cloud
Experience with release management tools such as JIRA and Confluence
Certified Fraud Examiner (CFE) or Accredited Health Care Fraud Investigator (AHFI) a plus
Certified Professional Coder-CPC or CCS preferred
The government services support team at Optum has earned the trust of organizations that our entire country relies on; from the Department of Defense and Veteran's Administration to the teams at Health & Human Services and the Centers for Medicare and Medicaid Services. We're repaying that trust with hard work, new ideas and a commitment to finding better solutions every day. Join us and help create ways for our government services agencies to be more efficient and effective. This will be the next huge step in your life's best work.(sm)
OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: Business Analyst, Systems Analyst, SQL, Medicare/Medicaid Analyst, data queries, Business Intelligence, Certified Professional Coder-CPC or CCS