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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

　　The health care markets are evolving in many different ways and the role and impact of the Medicaid is becoming increasingly important as health plans and providers look for new ways to grow and manage risk. In particular, the ability to manage medical cost through care management interventions or network management strategies is critical to the success of these organizations.

　　Optum is seeking a Healthcare Payer, Advisory Manager to provide Business Analysis expertise in the Government Payor markets. This position is responsible for the business analysis and operations consulting in all areas of Medicare Advantage, ACA and Medicaid products including LTSS, HCBS, Duals Population, Complex Care, Population Health, and provider sponsored organizations taking on risk for some of the most complex populations.

　　You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

　　Primary Responsibilities:

　　Responsible for gathering and documenting business requirements, solution, design and testing of Claims, Eligibility and/or Care Management Applications Documents and provides recommended business operational workflow Provides subject matter expertise in more than one of the following capabilities: Membership, Provider, Claims, Finance and/or Clinical domains Provide insight to clients around the CMS and state specific regulations, guidelines and policies around waiver programs and requirements Consults and engages with clients to resolve issues and presents options for resolution Define market needs and gaps to current capabilities Engages with other consultants to develop strategies, process, and workflow to support the client needs Ensures the requirements and deliverables meet the client needs and provides recommended solutions through business traceability matrices Creates relationships and delivers value to clients and business stakeholders Engages with the Business Solutions Architecture Teams to define application and technical solutions Escalates issues to business partners and leadership Supports program communication plan and execution Ensures quality assurance methods are implemented within programs Provide status updates and review of programs to senior leadership Establish trusted client relationships to expand the Payer Consulting footprint at designated clients Participates in a team-oriented work climate that enables professional development and encourages creative solutions and strategies Participates in Community of Practice leadership forums Ensures utilization rates are attained annually Obtains high client satisfaction scores (>90%)

　　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.

　　Years of post-high school education can be substituted/is equivalent to years of experience.

　　Required Qualifications:

　　5+ years of experience working for a Medicare Advantage, ACA, or Medicaid Health plan 5+ years of business analysis experience writing business requirements, user stories with traceability and end to end testing 3+ years of experience in a client facing consulting role 2+ years of documenting standard operating procedures (SOP's) 2+ years of System Analysis experience and creating business area context diagrams Experience in Business Analysis best practices Ability to recommend and implement applications efficiently for small to large payer or provider organizations Ability and willingness to travel up to 80% of the time when required

　　Preferred Qualifications:

　　Experience with CMS Regulations Experience with SQL Experience with agile methodology and agile applications Ability to develop reports Excellent presentation, writing and negotiation skills

　　*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

　　California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington residents is $101,200 to $184,000 per year. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

　　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.

　　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.