Medicaid Prospective Payment System Sr Product Analyst - Remote

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. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

EASYGroup™ offers a suite of software products that include analyzers, editors, groupers, mappers, pricers and data solutions that are used by over 200 payers to process their Medicare, Medicaid and TRICARE claims.  Our software is used to reimburse claims under the traditional Prospective Payment System (PPS) methodology by integrating with our customer’s claims adjudication platforms.

The Software is used to reimburse claims under the traditional Prospective Payment System (PPS) methodology and integrated with our customer’s claims adjudication platforms to perform the specialized functions associated with prospective payment methodologies (e.g. nuanced state and federal government regulations and the complex and ever-changing data sets that vary across our solutions).  It is also integrated with many other Optum solutions to “be the brain” behind their contract management, modeling, claims editing, etc.  

This role offers a great place to work and regularly presents new and exciting learning opportunities. 

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. 

Primary Responsibilities: 

• Analyze regulatory and business requirements as well as complex datasets, specifically for Medicaid prospective payment software solutions
• Write technical software specifications
• Work with software developers to implement changes from the specifications in software
• Test software to ensure that specified changes were correctly implemented
• Design and implement quality assurance procedures 
• Manage software release activities
• Provide product oversight, mentorship and/or regulatory training
• Troubleshoot and respond to regulatory and product inquiries
• Write documentation regarding product updates
• Lead new product initiatives 

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: 

• 4 years of experience with software development processes
• 4 years of experience with Quality Assurance and Auditing responsibilities
• 3 years of experience Prospective Payment Systems, comparing and analyzing datasets
• Experience with both State and Federal Medicaid regulations and claims processing experience 
• Very proficient at Word and Excel and proven ability to learn new software tools
• Proven solid problem solving and analytical skills
• Proven solid verbal and written communication skills
• Demonstrated ability to comprehend dense regulatory language

Preferred Qualifications:

• Experience with hospital based prospective payment reimbursement 
• Experience with CMS or State Medicaid Agencies
• Understanding of government regulations as it relates to Medicare/Medicaid/TRICARE
• Familiarity with claims processing software 
• Exposure to structured software coding 
• Exposure to writing software test-cases

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy 

The salary range for this role is $89,800 to $176,700 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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 marginalized 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: 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.  

Salary : $89,800 - $176,700