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Senior Business Analyst - Telecommute

Company: UnitedHealth Group
Location: Sugar Land
Posted on: November 22, 2021

Job Description:

If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm)The Senior Business Analyst (SBA) supports the TX Community & State Health Plan and is integral to our goals for the successful management of our Delegated Vendors: eviCore, ModivCare, Optum Behavioral Health, OptumRx, MARCH Vision, Dental Benefit Providers (DBP), OptumInsight, and Optum Health (which includes multiple programs). Additionally, the vendor oversite team coordinates HUB RFP submittals and management of the HUB program. From a compliance standpoint, the SBA ensures all Delegated Vendors are compliant state contracts and any changes; all Federal and State Regulations; and their contract with UHC Tx. The SBA will be responsible for verifying, creating and submitting all State Deliverables for our Vendors; monitoring of all metrics to ensure compliance; tracking and trending all vendor data to identify potential or ongoing contract risks; holding monthly meetings (JOCs) with the Vendor and Health Plan to review metrics and discuss issues; and be the point of contact between the Health Plan and the Vendor where we manage, escalate and help resolve concerns raised by the member, provider, or our State Partner. The successful candidate will act as a subject matter expert for their assigned vendors, manage metrics, set expectations for contractually required changes, create SOPs for internal staff, use astute analytical skills to address concerns prospectively. The Senior Business Analyst role is responsible for analysis, process and solution design for clinical system enhancements as well as managing and performing SharePoint enhancement requests. This is a position that affords the ability to drive processes and improvement initiatives by gathering and documenting business requirements and utilizing sharp analytical skills to fulfill the needs of the business. The role works with various internal clinical and technology teams to scope work, provide and present requirements and coordinate user testing and acceptance while leveraging Care Management experience to improve processes, technology and outcomes for the health plan. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities:

  • Manages new and existing vendor relationships
  • Accountable for the end-to-end process of identifying and implementing programs/vendor relationships
  • Identifies, interviews, vets, and contracts for services providing solutions to consumers in the health insurance market such as prescription vendor oversight, vendor billing and payments, as well as network relations and adequacy for medical, dental, and vision
  • Works closely with all internal departments and a variety of enterprise-level departments to ensure effective and appropriate product launch, monitoring, and revisions when appropriate
  • Anticipates what is happening in the market and plans and executes on insights learned; Translates data into a compelling business case and customer value story
  • Analyzes data from Key Performance Indicators and recommends appropriate actions; May direct other functional areas in data and metric requirements to meet product requirements
  • Uses creative thinking to solve problems and continually identify opportunities for improvement, Challenges current thinking and status quo
  • Works with matrix partners to translate required capabilities into concrete operational processes and measurement plans; Validates requirements with the state and internal partners; Pro-actively identifies needs/priorities of audience and provides relevant information when sharing insights, including facts and explanation of decision-making criteria
  • Communicates the product value story both internally and externally; Provides subject matter expertise and creates/maintains detailed product documentation
  • Researches and understands how market trends relate to and inform opportunities specific to their product/service area. Identifies key competitors and understands their position and strategy
  • Identifies opportunities to leverage technology to improve product capabilities; Shares learnings with others to influence change
  • Accurately translates technical terms and concepts to non-technical stakeholders; Effectively represents technical challenges and opportunities to external and internal stakeholders; Leverage's insights to adjust timelines and resource allocation
  • Has awareness of modern development principles, practices, and values and how it changes development processes/cycle
  • Excellent written and verbal communication skills
  • Ability to work independently
  • Solid analytical, organizational and time management skills
  • Ability to work in a fast-paced environment to meet tight deadlines 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:
    • Bachelor's degree
    • 5+ years of experience in health insurance industry, products, and services
    • 3+ years of experience working in matrixed environment
    • 3+ years of experience working in a role with a high degree of autonomy and minimal guidance
    • 2+ years of Project and/or Account ManagementPreferred Qualifications:
      • 2+ years of Network Management
      • 1+ years of Vendor Management
      • Experience in CommunityCare clinical application
      • Experience with medical product offerings and health plan designs
      • Demonstrated people, process and project management skills and experience, attention to detail, well-organized
      • Solid decision-making skills, analytic/problem solving skills
      • Ability to provide input to overall department planning, forecasting and process making decisions
      • Ability to work effectively in a fast-paced environment with shifting priorities
      • Excellent interpersonal skills - polished and professional To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment. Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low- income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $64,800 to $116,000. The salary range for Connecticut/Nevada residents is $71,400 to $127,400. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives 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: Senior Business Analyst, Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote

Keywords: UnitedHealth Group, Sugar Land , Senior Business Analyst - Telecommute, Professions , Sugar Land, Texas

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