Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
Positions in this family are related to the manipulation and analysis of data in support of a variety of analytic solutions. Roles within the family work with vast amounts of data from multiple sources, including administrative claims data provided by payers and electronic medical record (EMR) data provided by providers, to develop predictive and prescriptive analytics to the enterprise.
Primary Responsibilities:
Positions in this function are responsible for the management and manipulation of mostly structured data, with a focus on building business intelligence tools, conducting analysis to distinguish patterns and recognize trends, performing normalization operations and assuring data quality.
Depending on the specific role and business line, responsibilities in this function could include:
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Clinical Code Mapping & Normalization
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Analyze local, proprietary, or EMR specific codes and map them to standard vocabularies such diagnosis codes, medication codes, lab codes, and other clinical concepts
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Define and maintaining crosswalks between source EMR codes and standard terminologies, including handling one to many and many to one mappings
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Apply clinical and coding knowledge to resolve ambiguous, deprecated, or conflicting codes
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Support normalization of lab test result, lab test unit, medication route of administration, medication unit and medication dosage form values
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Support the evolution of mapping and normalization approaches toward ontology-based semantic modeling, including aligning codes to standardized clinical concepts, hierarchies, and relationships to enable more scalable and reusable analytic logic
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Requirements & Specification Development
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Elicit and document business and data requirements for code standardization and normalization processes
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Translate clinical and analytic use cases into functional specifications for developers and data engineers
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Define mapping rules, inclusion/exclusion criteria, default logic, and versioning strategies for standardized code sets
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Data Quality & Validation
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Perform data profiling and impact analysis to assess the completeness, accuracy, and consistency of mappings
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Validate normalized outputs through sampling, reconciliation, and comparison against authoritative reference sets
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Identify data quality issues related to coding variation, incomplete mappings, or EMR source limitations and recommend remediation strategies
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Stakeholder Collaboration
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Partner with clinicians, informaticists, methodologists, data engineers, and analytics teams to ensure mappings meet clinical intent and analytic needs
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Act as a subject matter liaison between methodologists and technical teams during design, build, testing, and implementation phases
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Support user acceptance testing (UAT) and production readiness reviews for normalized datasets
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Documentation & Governance
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Create and maintain detailed documentation for code mappings, assumptions, exceptions, and transformation logic
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Support governance processes related to terminology updates, version upgrades (e.g., ICD annual releases), and change control
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Ensure traceability from source EMR values through standardized outputs for audit, regulatory, and quality reporting purposes
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Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
Required Qualifications:
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Bachelor's degree in health informatics, healthcare analytics, information systems, or a related field (or equivalent experience)
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5+ years of experience working with EMR/clinical data in a business analyst, data analyst or informatics role
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Hands-on experience with clinical coding systems such as ICD10, SNOMED CT, CVX, LOINC, CPT/HCPCS, RxNorm or NDC
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Familiarity with HL7 FHIR, clinical data models, or healthcare data warehouses/lakes
Preferred Qualifications:
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Experience working with hierarchical or graph-based data structures
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Experience with the U.S. healthcare system in payer, provider, or healthcare analytics organizations
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Working knowledge of SQL Server, DataBricks and data validation techniques
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Demonstrated applied use cases of AI tools and techniques for process improvement
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.
