UnitedHealth Group Inc. logo

Sr Data Scientist - Telecommute

UnitedHealth Group Inc.

  • Plymouth, MN
  • 4 days ago
  • $91,700–$163,700 Per Year

Highlights

Claims Validation & Testing: Leverage data from enterprise claims platforms, including CSP Facets and related adjudication systems, to validate business logic, investigate data discrepancies, and ensure alignment between estimated and actual claim outcomes. This role is responsible for leveraging large-scale healthcare claims data to generate actionable insights, improve claim estimation accuracy, validate business processes, and support enterprise claims adjudication and pricing strategies.

Numbers & Facts

LocationPlymouth, MN
IndustryHealthcare Services
Salary$91,700–$163,700 Per Year
Company Size10,000 employees or more
Year Founded1977
Websitehttp://careers.unitedhealthgroup.com/

Description

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 optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

We are seeking a highly analytical and results-driven professional to support healthcare claims analytics, pricing accuracy, and operational performance initiatives. This role is responsible for leveraging large-scale healthcare claims data to generate actionable insights, improve claim estimation accuracy, validate business processes, and support enterprise claims adjudication and pricing strategies. The ideal candidate combines solid analytical and technical expertise with a deep understanding of healthcare claims data, enabling effective collaboration across business, operations, product, and technology teams.

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

Primary Responsibilities:

Data Analytics & Insights:

  • Analyze large-scale healthcare claims datasets to identify trends, patterns, anomalies, and opportunities for improving cost accuracy, benefit validation, and operational efficiency
  • Conduct deep-dive analyses of claim performance metrics, including cost estimate accuracy, denial drivers, benefit validation outcomes, and claim adjudication results
  • Translate complex analytical findings into clear, actionable recommendations that support business decision-making and operational improvements
  • Develop analytical frameworks and performance measurement methodologies to evaluate claim outcomes and drive continuous process optimization

Data Engineering & Model Development:

  • Develop, enhance, and maintain data pipelines, datasets, and analytical models that support claims processing, pricing, and estimation workflows
  • Partner with engineering and data teams to ensure data quality, consistency, and reliable integration across enterprise data sources and platforms
  • Support the design and implementation of scalable analytical solutions that enable efficient reporting, monitoring, and decision support

Claims Validation & Testing:

  • Leverage data from enterprise claims platforms, including CSP Facets and related adjudication systems, to validate business logic, investigate data discrepancies, and ensure alignment between estimated and actual claim outcomes
  • Design and execute analytical testing strategies for trial claims, MBO validation runs, and large-scale claims testing initiatives
  • Measure and compare performance across claim adjudication engines, identifying root causes of variance and recommending corrective actions
  • Support defect identification, root cause analysis, and validation efforts throughout the claims lifecycle

Cross-Functional Collaboration:

  • Collaborate with product, operations, business, and technology stakeholders to support strategic initiatives related to claim estimation, adjudication, pricing accuracy, and operational excellence
  • Partner with subject matter experts to define requirements, validate methodologies, and ensure business objectives are accurately translated into analytical solutions
  • Serve as a trusted advisor by providing data-driven insights and recommendations to support program planning and decision-making

Reporting & Visualization:

  • Build and maintain dashboards, reports, scorecards, and visualizations that communicate performance metrics and key insights to stakeholders and leadership
  • Present findings and recommendations to both technical and non-technical audiences, ensuring clear understanding of business impacts and opportunities
  • Monitor key performance indicators and proactively identify emerging trends or potential risks

Continuous Improvement & Automation:

  • Identify opportunities to automate recurring analytical processes and improve operational efficiency
  • Support continuous improvement initiatives through process optimization, advanced analytics, and data-driven recommendations
  • Contribute to the development of scalable analytical tools, testing frameworks, and reusable reporting assets

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:

  • 5+ years of experience in healthcare analytics, claims analytics, data science, or a related analytical role
  • Solid knowledge of healthcare claims processing, claim adjudication, pricing methodologies, and benefit structures
  • Experience working with healthcare claims platforms such as Facets, CSP, or other enterprise claims adjudication systems
  • Advanced SQL and data analysis skills, including experience with large datasets and cloud-based analytics platforms (Databricks, Snowflake, Azure, etc.)
  • Proficiency in data visualization and reporting tools such as Power BI, Tableau, or similar platforms
  • Experience presenting analytical findings to both technical teams and executive stakeholders
  • Solid problem-solving, analytical thinking, and communication skills
  • 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.

About Company

UnitedHealth Group is a health care and well-being company that’s dedicated to improving the health outcomes of millions worldwide. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others.

What we do

Gain insights on how we work to help people live healthier lives and help make the health system work better for everyone by watching this video.

https://www.youtube.com/watch?v=5PbNyi2IDkY

Caring. Connecting. Growing together.

Being a part of UnitedHealth Group means working to improve health outcomes for everyone, including yourself. Here is how:

Caring. Your total health and well-being are important to us. Whatever matters most to you — we have resources to help you be your best at work and at home. The benefits range from free Peloton courses to financial counseling. Learn more about what we offer.

Connecting. We recognize our collective power to make an impact across our communities because we believe the health of any society is measured by the overall health of its people. Learn more about our culture.

Growing together. UnitedHealth Group is full of inspiring career stories, and we offer a lifetime of opportunities. Discover all the ways you can learn, grow and develop.

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