Business Operations Specialist

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.

This Business Operations Specialist position is required to handle increased workload associated with Prior Authorization system setup. The Prior Authorization system setup includes the loading of letters, updating of tables, loading clinical guidelines, and updating automated decision trees.

This role is vital since without it we will risk incomplete guidelines, incomplete or incorrect approval and denial letters loaded for each client for each migration resulting in increased cost to client and decreased member satisfaction.

Primary Responsibilities

• The Business Intelligence Reporting position will primarily be responsible on all the reporting and analytic needs of Complex Claims - Philippines/Onshore
• Currently the RA is supporting our current headcount of PHL Complex Claims of 140. With the said headcount, the analyst will be a critical role to ensure we maintain and improve performance through data monitoring and reports analysis
• Using skills in Power BI, SQL, Python, Visual Basic, and MS Excel, the analyst generates insightful business intelligence and strategic information fostering optimal data-driven decision-making
• 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
  
  

• Solid writing and documentation skills
• Organizational skills
• Creativity
  
  

• Bachelors degree
• 2+ years of experience as a Report Analyst or in a related field
• Advanced to expert experience with Power BI
• Advanced to expert proficiency in SQL
• Basic knowledge of Python and Mastery of MS Excel
• Proven good communication skills
• Willing to work onsite in Makati and Night shift availability
  
  

• Snowflake and Tableau experience