Requisition number: 2352976
Job category: Business & Data Analytics
Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.
The Federal Reporting Business Analyst plays a pivotal role in the design, implementation and support Federal Reporting functionality within the Enterprise Data Services (EDS) project by serving as the functional bridge between CMS federal reporting requirements and the technical data warehouse solution within the EDS. This role will be responsible for translating complex regulatory reporting requirements (e.g. CMS-64, T-MSIS and PERM) into clear business and data requirements. This role will also support timely deliverables and audit requests. The Federal Reporting Business Analyst will work closely with Agency program staff and policy experts as well as Optum Data architects, ETL developers, QA teams, and Reporting/analytics partners. The role focuses on understanding how Medicaid programs are funded and supporting regulatory compliance efforts.
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:
Interpret Federal and regulatory program rules and translate them into data and reporting requirements as they pertain to CMS-64, T-MSIS, PERM
Develop and maintain key documentation such as Business Requirement Documents (BRDs), Functional Requirement Documents (FRDs), Data mapping and transformation specifications, Business rules and calculation logic etc.
Define and document:
Source system dependencies (MMIS, Eligibility & Enrollment systems, Provider systems, MCO files)
End-to-end data flows from source to warehouse to analytics
Data quality and completeness expectations
Federal policy communications
Validate requirements with program, operations, and policy stakeholders
Support business validation by performing data analysis queries
Support development of new federal reports and audit requests, as needed
Decompose high level business requirements into detailed work breakdown structures, including user stories, use cases, and implementation tasks.
Partner with ETL / ETL developers to review and validate Source-to-target mappings and transformation logic reflecting Medicaid business rules
Ensure data warehouse outputs are usable, well-defined, and aligned with business expectations
Act as a key liaison between the different teams such as ETL, Reporting, Data Governance etc.
Facilitate working sessions and design workshops to align program rules and data usage
Proactively identify risks, dependencies, and gaps in requirements or data readiness
Demonstrates accountability for understanding and aligning with the mission and goals of the role and department; consistently meets objectives while fostering a collaborative, engaged, and high performing team environment.
Leverage enterprise-approved AI tools to streamline workflows, automate tasks, and drive continuous improvement
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
5+ years of experience with Microsoft office applications
3+ years of experience working with Medicaid programs or MMIS
3+ years of experience in Medicaid Claims Processing or similar systems
3+ years of experience working with federal reporting (CMS-64, T-MSIS, PERM)
3+ years of experience supporting Enterprise Data Warehouse or Large-scale data modernization initiatives
3+ years of experience in SQL analyzing large healthcare datasets
Preferred Qualifications:
Experience working directly with state Medicaid agencies or Medicaid system vendors
Knowledge of Medicaid Enterprise Systems (MES) and modular architectures
Experience working in Agile or hybrid delivery environments
Experience working with Azure Dev Ops
Key Skills & Competencies:
Medicaid domain expertise (claims, recipient, provider)
Business analysis and requirements management
Data analysis and validation
Clear communication across technical and business audiences
Attention to detail and analytical problem-solving
Ability to translate operational workflows into data logic
Collaborative and proactive mindset
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay 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 salary for this role will range from $91,700 to $163,700 annually 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.
