1. Review and resolve complex cases with an end to end mindset to prevent issues or inquiries from recurring. Scope open inventory for like issues for cases worked to group and resolve batches.
2. Demonstrate a knowledge of end-to-end processes of multiple different types of capitated and delegated arrangements within the Value Based Care Model
3. Identify and articulate trends occurring within a risk entity or across multiple risk entities within claims processing and cost share application
4. Identify and articulate trends with our assigned delegates with the Sr. Issue Resolution Analyst and partner to work towards shift left initiatives
5. Partner and collaborate internally and with Risk Entities to correct claims processing and cost share application errors to prevent recurring issues. Actively participate in meetings with cross functional areas aligned by risk entities to share findings
6. Identify and communicate opportunities for improving issue resolution processes, including automation. Clearly document findings and solutions for trended issues after performing root cause analysis
7. Perform reconciliation of member inquiry cases, respond to the specific issue of the inquiry, as well as review for and resolve other issues that may be present for the member, outside of the inquiry
8. Support and communicate with the Sr. Issue Resolution Analyst assigned to your Delegate. Perform root cause and trend analysis of issues by assigned Delegate. Clearly document findings and solutions to prevent future issues
9. Communicate effectively (both written and verbal) with business partners.

Role: Business Analyst

Industry Type: Retail

Department: Data Science & Analytics

Employment Type: Full Time, Permanent

Role Category: Business Intelligence & Analytics

Education

UG: Any Graduate

PG: Any Postgraduate

About company

Careers at Optum

If you e going to change careers, why not look for an employer thats out to change everything? If you have that kind of appetite for change, Optum is the right place for you. As part of the growing UnitedHealth Group family of businesses, we e driving innovation and change all over the world. Thats creating opportunity right here in India for people with energy, passion and a focus on quality. We e driven to help people live healthier lives and to help make the health care system work better for everyone. We want to make a difference and that makes this the one job opportunity that can change everything for you.

As part of UnitedHealth Group, a Fortune 6 company, Optum is a leading health services and technology company dedicated to helping make the health system work better for everyone. With more than 115,000 people collaborating worldwide, Optum combines people, technology, data and action to improve the delivery, quality and efficiency of health care.

This work takes all of your commitment, skills, passion and energy. Its hard to become #1 and even harder to stay in the lead. Thats why we rely on a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care.