Technical Business Analyst - Payment Integrity - Remote

Optum is a leading healthcare company focused on improving the flow of health data and information. As a Technical Business Analyst supporting Payment Integrity, you will deliver analytics and reporting solutions, translating stakeholder needs into actionable requirements while collaborating with various teams to ensure data governance and quality.

Responsibilities:

• Partner with Payment Integrity business leads to define and refine requirements for the Commercial Provider Scorecard, including measures related to payment accuracy, audit outcomes, provider performance, and operational effectiveness
• Support analytics use cases tied to the Commercial book of business, ensuring requirements reflect nuances across lines of business, provider types, and commercial contracts
• Develop clear business definitions and metric logic to support consistent interpretation of scorecard measures across stakeholders
• Elicit, analyze, and document business, functional, and technical requirements for Payment Integrity BI initiatives, with an emphasis on scorecard and dashboard reporting
• Translate requirements into user stories and acceptance criteria aligned to Payment Integrity priorities and commercial reporting timelines
• Document data flows, source-to-target mappings, and transformation logic for Commercial Payment Integrity data sets
• Act as the primary liaison between Payment Integrity stakeholders and Data Engineering / BI delivery teams
• Support Agile ceremonies (Sprint Planning, Reviews, Retrospectives) to ensure Commercial Provider Scorecard deliverables are well-scoped, prioritized, and understood
• Actively manage risks, dependencies, and issues related to Commercial reporting deliverables
• Partner with Compliance, Privacy, and Data Governance teams to ensure Commercial Provider Scorecard data adheres to contractual, regulatory, and de-identification requirements
• Support data validation and UAT to ensure scorecard outputs accurately reflect Commercial Payment Integrity results before release
• Contribute to governance forums to align Commercial metrics, definitions, and lineage with enterprise standards
• Provide clear, concise updates to Payment Integrity and Commercial BI leadership on scorecard progress, risks, and upcoming milestones
• Support executive readiness by ensuring scorecard metrics are well-documented, auditable, and explainable

Requirements:

• Experience supporting Payment Integrity, Claims Auditing, Fraud, Waste & Abuse, or Provider Performance analytics, particularly within a Commercial line of business
• Hands-on experience delivering provider scorecards, operational dashboards, or performance reporting using Power BI and/or Tableau
• SQL querying experience
• Experience with Agile methodology including Agile tools (e.g. Rally, Jira)
• Experience with analyzing and documenting requirements
• Solid understanding of healthcare claims data, payment workflows, and commercial provider constructs
• All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy