Business Data Analyst

Business Data Analyst – Dublin or Letterkenny
Optum 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. Join us to help us advance health equity on a global scale.

Overview
The Business Data Analyst works at the intersection of data engineering and business strategy within our Healthcare Claims Analytics team. The role involves specification of business requirements, design of analytic automations for UHC claims data, identification of automation opportunities, and collaboration with global analytics partners.

Primary Responsibilities

Research potential autoload scenarios using SOPs to identify claims that can be fully automated.

Work with the data science team to build LLM/agentic solutions to source missing data from unstructured sources.

Identify algorithms that require agentic solutions for automation.

Develop and maintain recurring algorithms to detect overpaid claims and ensure accurate payment.

Ensure specifications are complete, consistent, concise, and achievable.

Refine criteria to build and enhance analytic logic and ensure correct claim coordination.

Communicate key analytic findings to Data Engineering via BRD documents.

Organize and manage projects, prioritizing work across multiple initiatives.

Gather, examine, analyze data and write technical specifications for data transformations.

Demonstrate understanding of project scope, data extraction, and data cleaning methodology.

Identify opportunities and formulate business questions to prototype solutions.

Collaborate with Business Analysts, Domain SMEs and stakeholders to define reporting requirements.

Deliver robust analytic solutions that scale for payers and provider markets.

Perform monthly algorithm performance analysis, comparing forecasts to actual outcomes.

Develop metrics to evaluate profitability and effectiveness of new algorithms.

Required Qualifications

Bachelor’s or higher degree in Information Technology, Healthcare, Clinical Research or equivalent.

Experience in data analytics within claims processes.

In-depth understanding of healthcare payment integrity, claim lifecycle, adjudication and pre‑adjudication.

Proficiency in analytical tools such as Excel, Power BI, PowerPoint and basic SQL or Python.

Ability to handle medium‑large data sets.

Strong project management skills and cross‑functional influence.

Excellent written and verbal communication for all management levels.

Experience with healthcare claims systems such as COSMOS, CSP, UNET, USP or NICE.

Preferred Qualifications

Medical coding/clinical certification (e.g., CPC, CPC‑H) or equivalent knowledge.

Scrum or Agile development experience.

Knowledge of Claims Cost Management (CCM) and legacy Optum applications.

Experience with UNET (PCOMM) and ISET applications.

Knowledge of E&I or M&R claims processing.

Soft Skills

Excellent organizational skills and attention to detail.

Strong analytical, complex thinking and problem‑solving abilities.

Effective communication and presentation skills.

Eligibility
Please note you must currently be eligible to work and remain indefinitely without any restrictions in Ireland. Proof will be required to support your application.

Equal Employment Opportunity
Optum is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to gender, civil status, family status, sexual orientation, disability, religion, age, race, membership of the Traveller community, or any other characteristic protected by law.

Optum is a drug‑free workplace.

About Optum
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. © 2024 Optum Services (Ireland) Limited. All rights reserved.

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