Leads HealthRules, Facets, or QNXT configuration design, system changes, and quality assurance testing for health plan processes. Gathers and documents requirements, configures benefits, pricing, provider, claims, enrollment, and utilization management functions, troubleshoots technical issues, validates changes, supports end-user training, mentors users, and coordinates project meetings and deliverables.
Requisition Number: 2383485
Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.
We are looking for a Sr. HealthRules, Facets, or QNXT Configuration Analyst with experience in Product/Benefits, Pricing, Provider, and Claims. The Sr. HealthRules, Facets, or QNXT Configuration Analyst will play an essential role in our clients' projects by leading HealthRules Facets, or QNXT configuration design, system changes, and quality assurance testing. The Sr. HealthRules, Facets, or QNXT Configuration Analyst will work with the Project team to gather and document requirements; develop or modify data, information, and functions for the Health Plan processes; including, but not limited to, benefit configuration, claims processing, clinical editing, utilization management, and enrollment.
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:
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:
*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 $91,700 - $163,700 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.
Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.
We are looking for a Sr. HealthRules, Facets, or QNXT Configuration Analyst with experience in Product/Benefits, Pricing, Provider, and Claims. The Sr. HealthRules, Facets, or QNXT Configuration Analyst will play an essential role in our clients' projects by leading HealthRules Facets, or QNXT configuration design, system changes, and quality assurance testing. The Sr. HealthRules, Facets, or QNXT Configuration Analyst will work with the Project team to gather and document requirements; develop or modify data, information, and functions for the Health Plan processes; including, but not limited to, benefit configuration, claims processing, clinical editing, utilization management, and enrollment.
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:
- Utilizing years of experience, designing efficient configuration solutions to meet the client's requirements and business needs
- Troubleshoots configuration and technical issues, and identifies modifications needed to meet changing user and regulatory requirements
- Reviews change requests to ensure consistency and compatibility to existing systems and procedures, including researching, validating, and resolving issues for accurate processing. Identifies, communicates, documents, and escalates information from all levels (end-users to leadership)
- Assists in the education and training of end-users. Supports development of expert users, and mentors inexperienced users
- Manages and facilitates meetings and presentations effectively and professionally to report progress and any issues. Prioritizes, plans, and organizes with Project Manager to ensure high quality results are completed on time
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:
- 5+ years of experience in configuration of product benefits, pricing, provider and claims using HealthRules Facets, or QNXT including technical knowledge of the database supporting the systems
- 5+ years of experience required in all or most of the following: Medicare, Medicaid, ACA, Commercial (small and large group)
- 3+ years of consulting experience in the Health Plan industry performing system implementations, process improvements and upgrades
- 3+ years of experience in eliciting requirements from business users to define and document project requirements, with the ability to perform business analysis and translate the outcome into definable software functionality
- Superior task management skills, with the ability to work under pressure, independently, or as part of a team in situations in which multiple priorities are likely
- Superb written and verbal English language communication skills, as well as interpersonal skills; able to communicate and influence peers, directors, and executives; to set clear expectations and realistic goals. Expert in the presentation of configuration ideas, status, solutions, and results
*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 $91,700 - $163,700 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.
Similar Jobs at Optum
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
Support accounting operations for assigned business areas, including month-end close, general ledger maintenance, journal entries, reconciliations, revenue recognition, financial analysis, reporting, and audit support. The role owns P&L and balance sheet activities, resolves accounting issues, maintains internal controls, improves processes, and partners with business and finance stakeholders to deliver accurate, timely results.
Top Skills:
Asc 606BlacklineGaapHyperion SmartviewPeoplesoft Financials
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
Serve as the primary finance business partner to Population Health Solutions leadership. Lead financial planning and analysis, month-end close, forecasting, long-range modeling, pricing and profitability analysis, investment decisions, budgeting, variance explanations, business cases, and cost-efficiency initiatives. Partner with product and business leaders to improve growth and profitability, manage intersegment agreements, support strategic initiatives, and develop domestic and offshore employees.
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
Analyzes complex business and operational data, develops forecasts and trends, presents recommendations, and supports strategic planning. The role translates business requirements into analyses, reports, dashboards, and scorecards while researching and implementing data-driven solutions. It requires proficiency with visualization tools, relational databases, Excel, and PowerPoint, with healthcare analytics experience preferred.
Top Skills:
Microsoft AccessExcelMicrosoft PowerpointPower BISQLTableau
What you need to know about the San Francisco Tech Scene
San Francisco and the surrounding Bay Area attracts more startup funding than any other region in the world. Home to Stanford University and UC Berkeley, leading VC firms and several of the world’s most valuable companies, the Bay Area is the place to go for anyone looking to make it big in the tech industry. That said, San Francisco has a lot to offer beyond technology thanks to a thriving art and music scene, excellent food and a short drive to several of the country’s most beautiful recreational areas.
Key Facts About San Francisco Tech
- Number of Tech Workers: 365,500; 13.9% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Google, Apple, Salesforce, Meta
- Key Industries: Artificial intelligence, cloud computing, fintech, consumer technology, software
- Funding Landscape: $50.5 billion in venture capital funding in 2024 (Pitchbook)
- Notable Investors: Sequoia Capital, Andreessen Horowitz, Bessemer Venture Partners, Greylock Partners, Khosla Ventures, Kleiner Perkins
- Research Centers and Universities: Stanford University; University of California, Berkeley; University of San Francisco; Santa Clara University; Ames Research Center; Center for AI Safety; California Institute for Regenerative Medicine

