UnitedHealth Group Facets Configuration Analyst Senior - Las Vegas, NV or Eden Prairie, MN in Las Vegas, Nevada

Energize your career with one of Healthcare’s fastest growing companies.

You dream of a great career with a great company – where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.

This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 6 leader.

Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

In this job, you would be responsible for defining and configuring various aspects in Facets required to accurately administer benefit and provider pricing. Additionally the person will be responsible to design and develop testing approaches to test configuration work.

Primary Responsibilities:

  • Analyze products, contracts and pricing, design / configure claim rules and clinical rules, conduct configuration validation, and perform configuration peer review.

  • Lead requirements gathering with business partners

  • Evaluate business requirements and determine global design

Required Qualifications:

  • HS Diploma / GED

  • Ability to work Monday to Friday 8am - 5pm

  • Institutional and Professional Claims processing experience

  • 2+ years of system configuration experience or facets claims experience at a health plan or delegated entity

  • Coding experience in one or more of the following: CPT, HCPCS, ICD9 / ICD10, Revenue, DRG or other relevant medical and industry - standard codes

  • Experience building and running SQL queries using tools such as MS Access, Query Builder, or similar

  • Knowledge of supporting tools from Trizetto and other vendors such as CMU, EncodePro, or similar

Preferred Qualifications:

  • Bachelor's Degree or higher

  • 4+ years of facets configuration experience

  • Experience with Facets data model

  • Experience working with supporting tools from Trizetto and other vendors such as CMU, EncodePro etc.

  • Knowledge of Medicare Pricing

Careerswith Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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 bestwork.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.

Keywords: coding, claims, process, Access, SQL, configuration, analyst, query, facets