Sr Data Analyst / Medicaid SME - Springfield, IL

Unitedhealth Group Inc. Springfield , IL 62701

Posted 3 months ago

Primary Responsibilities:

  • Analyze Medicaid enrollment, provider and claims data and document requirements, use cases.

  • Identify and document data anomalies and collaborate with cross functional teams for effective resolution

  • Share use cases to data analysts for profiling, review results and infer compliance to Medicaid / CMS processes and guidelines.

  • Able to juggle multiple priorities and ensure availability to questions and clarifications from data analysts.

  • Be a self-starter and able to thrive in a environment with little guidance.

Required Qualifications:

  • Bachelor's degree in related field or equivalent experience

  • 10 years of Healthcare data analysis experience supporting business initiatives through data analysis, writing business requirements and user acceptance testing of various systems

  • 4 years experience in working with State Medicaid and CHIP agencies

  • Experience working with PERM, TMSIS, CMS Federal Reporting or similar projects

  • Experience in HEDIS , CHIPRA or similar quality metrics

  • In-depth knowledge of CMS reporting requirements for Medicaid

  • In-depth understanding of FFS, Managed Care claim adjudication processes from enrollment to funding/finance.

  • 3 years of managed care encounters experience

  • Knowledge of health insurance, HMO and managed care principles including Medicaid and Medicare regulation.

  • Knowledge of Affordable care act and eligibility

  • Able to perform Complex Data analysis using SQL, Excel against data warehouses utilizing large datasets

  • Versatile in working with relational databases preferably Oracle

Preferred Qualifications:

  • Knowledge of Quality of Care program is highly preferred

  • Strong time management and organizational skills

  • Excellent interpersonal, oral and written communication skills

  • Effective organizational, analytical, time management, problem-solving, and multi-tasking skills and habits; ability to complete assignments under tight deadlines with little/no direct supervision

  • Knowledge of data integration, software enhancements/planning and Agile methodologies

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world?s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to 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.

Job Keywords: Medicaid, customer facing, business, Springfield, IL, Illinois

icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Personal Banker 1 Nmls Sixth St Branch Springfield IL (FT / 30 Hrs)

US Bank

Posted 1 week ago

VIEW JOBS 9/12/2019 12:00:00 AM 2019-12-11T00:00 Personal Bankers at U.S. Bank break the mold of what it means to be a banker by building a meaningful relationship with every customer. They are responsible for assessing and attending to customers' banking needs, obtaining and processing customer and account information and selling bank deposit and loan products and services. Personal Bankers inform customers of other products and services that meet their needs. They are also responsible for originating and closing consumer loans, opening accounts, performing sale deposit transactions, and opening and/or closing the branch. Personal Bankers build relationships with customers based on trust, recommending financial solutions based on each customer's unique goals and needs. At U.S. Bank, you'll get the support and tools you need to meet your goals and build a meaningful career. We reward top performance and ethical team players. Eligibility for incentives is based on sales referrals, branch growth and/or customer satisfaction. Personal Bankers have flexible schedules that may include weekends (depending on branch location). We're looking for people who want more than just a job – who want to make a difference in the communities where we live and work. Apply today and explore what's possible with a career at U.S. Bank. This position requires National Mortgage Licensing System (NMLS) registration under the terms of the S.A.F.E. Act of 2008 and Regulation Z. You will be subject to the required registration process, which includes a criminal background and credit check. Failure to meet or maintain any of the NMLS registration requirements, including maintaining a satisfactory criminal and credit record, may result in a rescission of your offer or termination of employment. Basic Qualifications * High school diploma or equivalent * One or more years of business related and/or retail experience, preferably including financial sales Preferred Skills/Experience * Ability to sell traditional bank products and process transactions * Thorough knowledge of retail product philosophy, policy, procedures, documentation and systems * Thorough understanding of banking operations, product knowledge, sales, and new business development * Excellent customer service/relations and community relations * Strong interpersonal, verbal and written communication skills * Ability to identify and resolve/escalate problems * Ability to complete Know Your Customer (KYC) Program certification upon hire US Bank Springfield IL

Sr Data Analyst / Medicaid SME - Springfield, IL

Unitedhealth Group Inc.