Care Management Business Analyst – Remote

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.The CM Business Analyst serves as a strategic connector between the Clinical Operations team and Care Management units. This role is responsible for translating care coordination needs into valid business processes and clinical system configurations, ensuring operational alignment and data integrity across platforms such as Essette. The BA also leads quality review efforts focused on documentation standards, workflow accuracy, and process compliance for care coordination programs. Serves as a resource for other departments, providing operational information that will enhance and/or maintain their current structure within the system. Takes lead in creating training materials utilized while conducting end-user training, internally and externally for community partners throughout the state for care management. Leads and supports the care management department in achieving accurate and timely measurements. Utilize leadership and technical skills to provide direction for the care management Essette projects. Facilitates the development of Essette for company-based initiatives. This position will support continued support for program development and compliance for CM.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:

• Partner with care management teams to understand program goals, workflows, and system needs
• Translate clinical and operational requirements into system configurations and business processes
• Collaborate with SDoH managers and community care teams to ensure data flows (e.g., housing, food, SHIE) are accurately captured and integrated
• Design and implement workflows for care coordination campaigns, including front-end interfaces
• Lead quality audits of care coordination documentation and workflows to ensure compliance with internal standards and external regulations
• Assist in development of dashboards and reporting tools to monitor performance metrics
• Facilitate feedback loops with care teams to continuously improve documentation practices and workflow efficiency
• Participate in clinical strategy sessions, estimation calls, and redesign meetings to align care coordination efforts with broader organizational goals
• Act as a liaison between clinical teams, IT, and business operations to ensure seamless integration of care coordination tools and processes
• Works collaboratively with CM management, IT, and other departments using the Essette system in accordance with the Mission and Values of the company to perform the assigned duties
• Responsible for analyzing and improving business processes within the Care Management Department. Act as point for system development and process design for existing and new programs
• Serve as a direct point of contact for developing Essette care management centered processes with internal teams and external partners. Ensure clear project definition, design, communication, implementation, monitoring and support. Work with stakeholders to establish areas for integration
• Schedule, track and provide oversight for care management system development projects. Including timing of development and implementation for Essette projects
• Maintain working knowledge of all CM systems. Be a Subject Matter Expert in all areas of CM system to continually evaluate workflow and process to facilitate the most efficient and streamlined processes
• Utilize individual thought and department expertise to organize and validate data to manage the development of reports, e.g., production reports, regulatory reports, utilization reports, compliance reports for internal and external audits, and validation of reports
• Respect confidentiality and maintain confidences as described in the UHG Employee Handbook and acknowledged through signature by all employees. The ability to maintain confidentiality is a critical and essential component of this position
• Maintains system efficiency. Ensures the design of the system allows all components to work properly for the department and others utilizing it. Engages in necessary resources to address needs in a timely manner. Makes recommendations for future upgrades
• Assess, monitor and improve work processes and work with Director to implement changes. Ensures changes are communicated and integrated with in the department and for external partners
• Collaborates with Management to develop and run program reports. Assists with data definitions and works closely with Data Analyst teams to ensure accurate reporting. Scrub report files for accuracy. A point of contact for navigation of the CM modules for audits
• Complete all duties in accordance with company safety policies and practices
• Other functions may be assigned, and management retains the right to add or change the duties at any 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:

• 2+ years of healthcare industry, system support or care coordination experience
• 2+ years of data analytics or process improvement experience
• Microsoft systems knowledge
• High level of proficiency with excel
• Analytical and problem-solving skills, effective communication skills with technical staff and end users
• Demonstrated ability to read, analyze, interpret technical procedures, and to identify and manage routine problems
• Demonstrated ability to make decisions, multi-task, and to learn new technologies
• Demonstrated ability to travel, as needed

Preferred Qualifications:

• Demonstrated ability to determine how a system should work and how changes in conditions, operations, and the environment will affect outcomes
• Demonstrated ability to use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems
• Demonstrated ability to identify measures or indicators of system performance and the actions needed to improve or correct performance, relative to the goals of the system
• Demonstrated ability to identify complex problems and reviewing related information to develop and evaluate options and implement solutions
• Demonstrated ability to determine causes of operating errors and deciding what to do about it
• Demonstrated ability to conduct tests and inspections of products, services, or processes to evaluate quality or performance

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter PolicyPay 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 hourly pay for this role will range from $28.27 to $50.48 per hour 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.

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