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We are seeking a Senior Business Process Analyst- telecommute opportunity. Responsible for managing the design and project implementation teams in process improvement activities and lead the implementation and execution of programs on behalf of UHC Payment Integrity. Work with health insurance claims, FWA lead, regulatory, and other reporting databases, sources and systems. Responsible for process design, analysis and improvement by utilizing knowledge of healthcare claims processing and systems, government program, customer and business payment integrity requirements, case management applications and technical systems and tools. Responsible for identifying, communicating, developing, recommending, implementing and delivering on effective action plans for payment integrity regulatory adherence initiatives. Responsible for supporting, contributing to and/or facilitating the identification/prioritization of business/process solutions (e.g., analysis tools, solutioning discussions, use case development). Responsible for diagnosing process improvement opportunities and developing solutions using principles of process excellence and related tools. Responsible for identifying capability gaps between current state and desired state (e.g., system capacity, emerging technologies). Work with operations to ensure that implementation project plans are developed and executed while building and maintaining detailed knowledge of business products, solutions, systems, and processes in order to effectively manage process improvement projects. Responsible for developing and maintaining strong working relationships with business leadership, legal colleagues, compliance, regulatory adherence and subject matter experts to partner closely with functional owners within the assigned business and the organization to collaborate on process improvement opportunities and provide consultation and recommendations as needed. Create business specific reporting to communicate key information and share status updates with stakeholders. Responsible for identifying solutions to non-standard requests and problems; assessing and interpreting customer needs and requirements; solving moderately complex problems and conducting moderately complex analyses; working with minimal guidance; seeking guidance on only the most complex tasks; translating concepts into practice; providing explanations and information to others on difficult issues; coaching, providing feedback, and guiding others; acting as a resource for other with less experience; driving the gathering of detailed business, functional, and non-functional requirements; identifying applicable technical business stakeholders using Stakeholder Analysis tools, RACI and SIPC; defining approach and effort required for outlining business requirements; defining and updating the project schedule to track and measure progress of the requirements gathering process; defining approach for strong and updating business requirements; adhering to established project lifecycle standards and requirements; and collaborating with business and technical stakeholders to identify specific business requirements. May telecommute from any U.S. location.
- Bachelor's degree or equivalent in Engineering, Computer Science or a related field.
- 5 years related progressive, post-baccalaureate experience.
- Must also have 3 years demonstrated ability with each of the following: 1) Process design, analysis and improvement by utilizing knowledge of healthcare claims processing and systems, government program, customer and business payment integrity requirements, case management applications and technical systems and tools; 2) Payment integrity systems; 3) Identifying, communicating, developing, recommending, implementing and delivering on effective action plans for payment integrity regulatory adherence initiatives; 4) Supporting, contributing to and/or facilitating the identification/prioritization of business/process solutions (e.g., analysis tools, solutioning discussions, use case development); and 5) Experience with health insurance claims, FWA lead, regulatory, and other reporting databases, sources and systems. Employer will accept experience gained concurrently. Employer will accept experience gained concurrently.
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)
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.