Sr Data Scientist - Telecommute

Healthcare Claims Analytics Professional

At United Healthcare, 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.

• 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

• 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

• 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

• 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

• 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

• Identify…