Transform health care and change the way consumers engage with technology.
Sounds like a big challenge, right? Here, at Optum, you have the opportunity to achieve great things while you showcase your passion and technical expertise as a Senior Datastage ETL Developer. You’ll be inspired by working alongside some of the most brilliant minds in technology who bring compassion, energy and focus to their work every day on a mission to change health care as we know it. Join us! Come share who you are and start doing your life’s best work.(sm)
Optum Payment Integrity (OPI) services group focuses on recovering overpayments on claims through the identification of these overpayments. Overpayment recover are determine utilizing Data mining, Coordination of benefit, Fraud Waste and Abuse and Subrogation process.
Data Mining (ARO) analytics process identifies claim overpayments based on a series of algorithms that are consistently being updated. Data Mining identification is enhanced through the use of external vendors and all identifications are subject to quality audit before being loaded into ODAR for recovery. The UPI team seeks to maximize identifications and their collectability while at the same time referring to CCM to prevent future overpayments from occurring.
Fraud Waste and Abuse analytics attempts to identify claims and claim patterns that indicate potential for provider fraud, waste or abuse using sophisticated algorithms and predictive models. Once aberrant billing patterns are identified medical records are requested to support the billing and determinations are made to flag the provider or pay the pended claims. Claims may be flagged both prospectively and retrospectively.
COB analytics seeks to achieve prospective claim savings through identifying members whose other group health insurance (typically Medicare or other commercial coverage) is primarily responsible for paying the claim thus reducing the client’s liability. The large portion of information must be gathered from the client’s members or the other insurer directly and often through telephone contact. COB savings continues for as long as the member has other coverage and coverage with the client.
Subrogation analytics process identifies situations where a member has been injured through another’s negligence and attempts to recover (subrogation) or avoid payment (ICC) on claims to make the injuring party responsible. Most common cases involve motor vehicle accidents, Workmen’s Compensation, medical malpractice and product liability.
- Engage with Internal clients to clearly define business requirements
- Perform complex data analysis to support research requests by the client
- Create technical specifications, unit test plans, dataflow diagrams and logical data models
- Follow quality assurance guidelines including the documentation, review and approval of all project related artifacts
- Troubleshoot client and operational issues quickly and comprehensively
- Lead developer for the planning, completion and coordination of work activity for projects involving multiple resources
- Research, evaluate, identify alternative approaches, recommend, design and code efficient and effective solutions for challenging problems ranging from small to large work efforts for low to moderate complexity problems
- Comply with standards and guidelines related to the design, construction, testing and deployment activities within the Delivery Management environments
- Demonstrate collaborative skills working within a project team of diverse skills and will bring communication skills including oral, written and presentation skills, creativity, and problem solving skills to a challenging environment
- Support, train and mentor fellow analysts and developers
- Improve operational processes
- Report project status timely and accurately from week-to-week
- Works with minimal guidance; seeks guidance on only the most complex tasks
- Function well within a matrix organization (e.g. – supporting multiple leaders)
To be considered for this position, applicants need to meet the qualifications listed in this posting.
- Bachelor’s degree in computer science, business or other relevant degree; OR equivalent experience of 5 years minimum in one or more aspects of information systems development
- 7+ years of IT experience
- 7+ years of Data/Technical analysis experience
- 5+ years of IBM Infosphere DataStage ETL tool (version 7.5.2 or greater)
- 5+ years of experience with SQL on relational databases, preferably Oracle, DB2
- 5+ years of UNIX or Linux development experience
- Location: Minnetonka, MN
- Experience working with a virtual team environment over multiple locations, including off-shore
- Effective communications with all levels of internal staff, including issue resolution, negotiation of project related priorities, and completion dates
- An understanding of a variety of modeling and/or diagramming techniques, with the ability to create process flow diagrams and the ability read data flow and entity relationship models
- Strong analytical and technical aptitude
- Tivoli (TWS) or equivalent job scheduling tool experience
- Exposure to complex, cross-departmental projects involving multiple platforms
- Ability to create detailed technical design and mapping specifications
- Ability to lead walk through of design documents
- Healthcare industry knowledge
- Knowledge of Hadoop and Java
- Master’s degree in computer science, business or other relevant degree
Careers with Optum. Here’s the idea. We built an entire organization around one giant objective; make health care 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 best work.(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.