Associate Business Analyst

Utilization Management 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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Join a high-impact team that sits at the intersection of clinical pharmacy, operations, and technology. In this role, you'll operationalize custom Utilization Management (UM) criteria within our UMCS (Utilization Management Criteria System) platform, partner closely with clinical consultants and pharmacists, and drive process improvements and automation-including early applications of AI-to enhance speed, accuracy, and scale across our UM workflows.

This position is full-time (40 hours / week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 5pm CST. It may be necessary, given the business need, to work occasional overtime.

We offer 8-12 weeks of paid training. The hours of training will be based on your schedule.

Primary Responsibilities :

• Partner with clinical consultants to translate client requirements into UM guidelines and operationalize custom UM criteria in UMCS accurately and on time.
• Support pharmacists by configuring and validating UM criteria in UMCS efficiently and with strong documentation.
• Build and maintain operational visibility : compile monthly reports, guideline compiles, and trackers to streamline inter departmental communications.
• Present with polish : share screen during high-profile meetings and seamlessly access, navigate, and present the right materials at the right moment.
• Improve processes : identify bottlenecks and assist in the design and implementation of process improvements that enhance efficiency and quality.
• Deliver ad hoc analysis and special projects with clear structure, timelines, and stakeholder updates.
• Analyze complex drug datasets including Medi-Span updates and GPI (Generic Product Identifier) structures; synthesize insights to inform UM decisions.
• Manage projects end to end, coordinating cross-functional dependencies through completion.
• Champion automation : propose and prototype ideas to automate recurring tasks; document and measure impact.
• Lead team education on AI : develop light training / enablement for practical AI use cases and responsible usage.
• Support validation / implementation of AI and automation solutions within UM operations (pilots, UAT, SOP updates).

Critical Competencies :

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 :

Preferred Qualifications :

Telecommuting Requirements :

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). The hourly pay for this role will range from $23.41 - $41.83 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.