Business Process Analyst - Medical Claims Review - San Antonio, TX

Careers at UnitedHealth Group

We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM

Clinical

Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work.(sm)

The Business Process Analyst reviews assigned business processes from end-to-end to identify and address operational, financial and technological risks. Identifies opportunities to improve process and manages improvement projects for MCR. Investigates non-standard requests and problems, makes presentations to direct management and completes projects on time and within scope. Assists in the design of inventory distribution systems and efficiencies.

Primary Responsbilities:
  • Coordinates and completes projects across various functional areas that support MCR initiatives
  • Leads Project Management initiatives as project assignments and / or identified as a result of a business process review
  • Performs moderately complex business analysis and project management
  • Tracks and reports on project status to colleagues and senior management
  • Documentation management (development and revisions) of assigned processes: workflows, policies and procedures, letters, etc.
  • Synthesizes data, develops recommendations, and reviews findings with business leadership
  • Prepares review documentation including Microsoft Visio process maps and PowerPoint presentations
  • Creates a process management system to monitor key performance indicators
  • Serves as a liaison between MCR, Quality and IT to assist and alter business requirements needed for system modifications, enhancements and implementations, even acting as Project Manager where experience is warranted
  • Performs all other related duties as assigned

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:
  • Bachelor's degree in a related field (4+ years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelor's degree)
  • 3+ years associated business experience with health care industry
  • 1+ years experience with process improvement initiatives
  • Experience in mobilizing teams and maintaining motivation to accomplish goals under stringent timelines
  • Proficiency with Microsoft Office applications to include Word, Excel, Visio, PowerPoint and Outlook
  • Working knowledge of Share Point
  • This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease
  • Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance

Preferred Qualifications:
  • Project Management experience
  • Medical/clinic background
  • Proven ability to successfully conceptualize an initiative, develop a plan and execute the plan through implementation
  • Ability to interact one-on-one and consult with all levels of executive management

Physical & Mental Requirements:
  • Ability to lift up to 25 pounds
  • Ability to sit for extended periods of time
  • Ability to use fine motor skills to operate office equipment and/or machinery
  • Ability to receive and comprehend instructions verbally and/or in writing
  • Ability to use logical reasoning for simple and complex problem solving


To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

Job keywords: Business Process Analyst, Medical Claims Review, Analyst, San Antonio, Texas, TX

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