Business Data Analyst

Business Data Analyst – Dublin or LetterkennyOptum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives.The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities.Come makes an impact on the communities we serve as you help us advance health equity on a global scale.Join us to startCaring.Connecting.Growing together.At UnitedHealth Group and Optum, we want to make healthcare work better for everyone.This depends on hiring the best and brightest.With a thriving ecosystem of investment and innovation, our business in Ireland is constantly growing to support the healthcare needs of the future.Our teams are at the forefront of building and adapting the latest technologies to propel healthcare forward in a way that better serves everyone.With our hands at work across all aspects of health, we use the most advanced development tools, AI, data science and innovative approaches to make the healthcare system work better for everyone.As the Business Data Analyst, your work area includes specification of BRDs for the development of analytic automations in healthcare professional and institutional claims data for UHC all Line of businesses.The role requires review of various non-clinical analytics, data-maps through domain expertise and advanced data analysis, identifying automation opportunities resulting in business impact, innovation or optimization algorithms and building strong relationships with global analytics teams.The role will focus on healthcare claims analytics, including overpayment detection and algorithm development.Primary responsibilities of the Business Data AnalystResearch potential autoload scenarios using the SOPs to identify claims that can be fully automated.Work with the data science team to build LLM/Agentic solutions to source missing data that is currently unavailable in unstructured data.Identify algos that require fully agentic solutions for automation.Develop and maintain recurring algorithms to identify overpaid claims and ensure accurate payment.Ensures team gathers right requirements from the business stakeholders and ensure that all specifications are complete, consistent, concise, and achievable.Identify and refine criteria to successfully build and enhance new and existing analytic logic, ensuring correct claim coordination.Communicating key analytic findings to Data engineering via a BRD document.Organize and manage time and resources; establish priorities and coordinate work on many projects simultaneously.Work to gather, examine, and analyze data; write technical specifications for manipulating data to look for trends.Demonstrate a strong understanding of project scope, data extraction methodology, design of dependent and profile variables, logic and design of data cleaning, exploratory data analysis.Identify opportunities, pose business questions, and make valuable discoveries to prototype development and rule improvement.Actively consult with business stakeholders, data scientists and subject matter experts to ensure appropriate medical and business content is incorporated into analytic approaches.Ability to work closely with Business Analysts, Domain SMEs to understand business needs and help define requirements for reporting solutions.Deliver robust and scalable analytic solutions in an automated state for payers and provider markets.Perform monthly analysis of algorithm performance, comparing forecasted vs. actual outcomes.Develop metrics to evaluate profitability and effectiveness of new algorithms.You will be rewarded and recognised 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 providing development for other roles you may be interested in.Required Qualifications of the Business Data AnalystBachelor's or higher degree in a related Information Technology field/Healthcare/clinical research or equivalent technical experience.Experience in data analytics and claims processes.In-depth understanding of healthcare, Payment integrity processes, Claim lifecycle, Adjudication & Pre-Adjudication process.Knowledge of analytical tools and techniques, especially those relating to data mining & analysis.Should have ability to handle/work on medium/large data sets.Proficiency in tools such as Microsoft Office Excel/PowerBI/PowerPoint; Working Knowledge of basic SQL or Python is desirable.Experience in research - ability to engage with auditors to fully understand wow different workflows are done.Strong project management skills, ability to influence cross-functionally in a rapidly evolving business environment while managing multiple / concurrent projects.Must be able to communicate ideas effectively and concisely to all levels of Management, business partners, and to other external clients and ability to work independently.Experience with healthcare claims systems such as COSMOS, CSP, UNET, USP, or NICE.Preferred Qualifications of the Business Data AnalystMedical coding/clinical certification like CPC OR CPC-H or any other medical certification/knowledge.Scrum or other Agile development experience.Knowledge of Claims Cost Management (CCM).UNET (PCOMM) & ISET applications (Internal to Optum).COSMOS -M&R (PCOMM) & ISET applications (Internal to Optum) - preferrable.Knowledge of E&I or M&R claims processing.Soft skills of the Business Data AnalystProven excellent written and verbal communication skills.Proven excellent organizational skills and attention to detail.Strong analytical, complex thinking, problem solving, and troubleshooting abilities.Please note you must currently be eligible to work and remain indefinitely without any restrictions in the country to which you are making an application.Proof will be required to support your application.All telecommuters will be required to adhere to the UnitedHealth Group's Telecommuter Policy.At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone.We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life.Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalised groups and those with lower incomes.We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.Diversity creates a healthier atmosphere: Optum is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to gender, civil status, family status, sexual orientation, disability, religion, age, race, and membership of the Traveller community, or any other characteristic protected by law.Optum is a drug-free workplace.© **** Optum Services (Ireland) Limited.All rights reserved.#J-*****-Ljbffr