Senior Consultant Business Systems

Requisition Number: 2375117
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.
Primary Responsibilities:

• Business Analysis & Stakeholder Management
  • Serve as the primary liaison between business stakeholders, Data Analysts (DAs), Software Engineers (SEs), Quality Engineers (QEs), and other cross-functional teams to ensure alignment of business objectives and technology solutions
  • Facilitate requirement-gathering workshops, discovery sessions, and working meetings to drive clarity on complex business and technical problems
  • Analyze business processes, identify gaps, and translate business needs into clear, detailed, and actionable system requirements, user stories, and functional specifications
  • Communicate project status, risks, dependencies, recommendations, and insights effectively to leadership and stakeholders
  • Build and maintain strong relationships across program teams to foster collaboration and ensure successful delivery outcomes
  • Solution Analysis & System Design
  • Consult with business users and technology teams to define, evaluate, and improve business processes and supporting information systems
  • Develop high-quality system solutions that align with business strategies, enterprise architecture standards, and operational requirements
  • Create and maintain functional designs, process flows, data mappings, system documentation, and business rules
  • Support the design of integrated technology solutions that work cohesively across applications and platforms while adhering to enterprise standards and best practices
  • Partner with development and testing teams throughout the Software Development Life Cycle (SDLC) to ensure solutions meet business requirements and quality expectations
• Artificial Intelligence (AI) & Innovation
  • Identify opportunities to leverage Artificial Intelligence (AI), Machine Learning (ML), automation, and digital technologies to improve business processes, operational efficiency, and customer experience
  • Partner with business and technology teams to evaluate, recommend, and implement AI-driven solutions that deliver measurable business value
  • Analyze existing workflows and identify opportunities for intelligent automation, predictive analytics, generative AI, and decision-support capabilities
  • Promote AI awareness and adoption across teams through knowledge sharing, best practices, and continuous learning initiatives
  • Ensure AI-enabled solutions align with organizational governance, compliance, security, and responsible AI principles
• Risk Management & Problem Solving
  • Proactively identify project, system, and operational risks and recommend mitigation strategies
  • Diagnose and resolve complex business and system issues while balancing business priorities, technical feasibility, and delivery timelines
  • Drive root cause analysis efforts and support implementation of sustainable corrective actions
  • Identify and develop innovative solutions for non-standard business and system challenges
• Leadership, Mentoring & Collaboration
  • Provide coaching, guidance, and constructive feedback to System Analysts and other team members
  • Support knowledge transfer initiatives and conduct training sessions for business, claims, and analyst teams
  • Lead analysis efforts on complex initiatives and drive alignment across multiple stakeholders and workstreams
  • Foster a culture of continuous improvement, collaboration, innovation, and accountability
  • Work effectively as both an individual contributor and a collaborative team member in a dynamic and virtual environment
  • Actively participate in Scrum ceremonies, including backlog refinement, sprint planning, reviews, and retrospectives
  • Support teams in achieving business goals through effective prioritization, analysis, and delivery support
  • Continuously evaluate processes and identify opportunities for efficiency improvements, standardization, automation, and enhanced customer outcomes
• 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:

• B. Tech./MCA/ M. Tech (Minimum 16 years of formal education )
• AHM 250 certification
• 7+ years of U.S. HealthCare Domain experience, solid data driven analysis, Business Documentation, Data Models, data discovery, data warehouse ,database and Business Intelligence
• Experience in all phases of SDLC
• Experience in writing crisp and clear requirements
• Experience in translating business requirements in to detailed system specifications
• Experience in Claim domain is huge plus specially on claim processing/adjudication
• Extensive hands-on experience on writing SQL queries, MS Excel analysis, RDBMS, data joins
• Extensive experience in Data modelling, Database and Data warehousing and Business reporting applications
• Hands-on experience in Data analysis, Business Intelligence tools (Tableau), Database and Data warehousing applications
• Good experience on CA Rally and JIRA tools
• AI work experience and exposure will be preferred
• Exposure to Healthcare standards like EDI is a huge plus
• Good Understanding of API and Webservices
• Creating XML, XSD and JSON files and experience in mapping data from webservices or database to user interface
• Proven excellent verbal and written communication skills
• Proven to be Self-Driven and out of the box thinker
• Flexible to work in changing shifts with project requirements

Preferred Qualifications:

• Knowledge of US Healthcare domain
• Exposure to Healthcare standards like X12 and HL7

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.