FWA Manager - 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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
Program Integrity Analytics is a suite of complementary, web-based components that mine provider, member and claims data for potential fraud, waste and abuse; provide software research tools; and track subsequent investigation activity. The team is comprised of individuals with a variety of technical expertise from databases, business intelligence reporting, and web-based tools.
We are looking for a strong manager able to lead a team of data analysts in support of fraud, waste and abuse detection with the PI system. The manager will be involved in multiple projects, primarily operational support and assisting with requirements and acceptance of implementations. This individual must have the ability to collaborate with internal technical roles including data engineers, software engineers and report developers. Technical knowledge includes familiarity with database structures, testing software, documentation procedures, User Manual formats and ability to train new users. This role is key in the successful implementation of new projects and the maintenance of existing projects.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:

• Support the full software development and implementation lifecycle
• Analyze and dissect system requirements and technical specifications to create and execute test cases for business initiatives
• Validate requirements with stakeholders and provide suggestions and recommendations
• Work with business users, data analysts, designers, and developers to create and analyze various required project documents - this includes detail specifications for complex algorithms
• Ability to write clear, concise, and extensive user documentation using advanced features of MS Word
• Ability to write user stories with measurable results (acceptance criteria); manage the process by hosting/attending daily stand-up meetings and participation in retrospective and planning meetings
• Effectively communicate with multiple roles, including business stakeholders/SME's, PM's, developers, system architects, etc.
• Assist business users in defining User Acceptance Testing, test cases, and plans
• Ability to write test cases and execute testing within a web service environment
• Plan, document, evaluate and track testing results to ensure system applications are free from defects
• Establish and maintain test cases and test data, includes knowledge of SQL
• Ability to use advanced features of MS Excel such standard deviation, formulas, and other functions
• Actively participate in walk-through, inspection, and peer reviews for quality assurance
• Participate in production implementation verification and being accountable for validating system quality
• Communicate and interact with appropriate areas on problems, changes and enhancements that may impact data, workflow and/or functionality within Information Technology software
• Comply with standards of the software development life cycle and follow strategies, plans and procedures within information Technology software
• Ability to share knowledge (train) other team members and business users on any of the skills listed above
• Collaborate with project stakeholders and technical teams regarding enhancements, changes, issues, and defects that may impact development, data, workflow and/or functionality
• Ability to manage multiple clients simultaneously and oversee the analysts supporting each client
• Travel to customer sites as necessary to support the software development life cycle
• Travel to customer sites may be required (up to 25%)

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:

• 10+ years of business analysis experience in the healthcare fraud, waste and abuse
• 10+ years of data analysis experience, a working knowledge of database structure and SQL
• Experience gathering and writing business requirements
• Experience writing training materials and user manuals
• Experience conducting instructor lead training
• Expert knowledge of claims processing, with an understanding of how policy impacts claims

Preferred Qualifications:

• Medical coding certification (AAPC, AHIMA or PMI) or AHFI certification from NHCAA
• Certified Fraud Investigator (CFE)
• Experience with Rally
• Experience in managing people
• Medicaid claim & policy experience

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $112,700 to $193,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.