• Perform detailed trend analysis and root cause investigation across Low Balance inventory, including denials, payment variances, adjustments, and returns. • Analyze claims, remittance, and payment data to identify payor behavior patterns, emerging issues, and revenue risks. • Support payor escalation preparation by completing detailed account reviews, summarizing findings, and documenting recommended next steps. • Maintain accurate payor escalation documentation, including issue details, supporting analysis, and resolution outcomes. • Perform monthly revenue reconciliation to ensure accuracy and completeness across source systems. • Execute analysis for trending requests and participate in cross-functional reviews to discuss findings and recommended actions.

• This FM Transformation Analyst will work in Guidehouse’s Financial Management (FM) practice supporting Department of War clients. • You will support initiatives that transform core financial management functions and operations. • Our finance transformation consultants help our clients across the Department of War optimize all elements of their technical data structures and automations by transforming business processes and enhancing the efficiency of technical data operations. • This role focuses on driving finance and accounting excellence through leveraging technology solutions to deliver actionable insights, enhance operational efficiency, enable auditability, and modernize financial processes in alignment with federal standards.

Role Description Employees are responsible for triaging, investigating, and resolving potential instances of healthcare fraud and/or abusive conduct by medical professionals or providers. Using information from tips, complaints, external intelligence or behavior data, the medical community and law enforcement, employees conduct confidential investigations and document relevant findings and report any illegal activities in accordance with all laws and regulations. Identify, communicate, and recover losses as deemed appropriate. These investigations may include participation in telephone calls or meetings with providers, members, clients, legal compliance, and other investigative areas and requires adherence to state and federal compliance policies, reimbursement policies, and contract compliance. You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Gather and analyze data and information gathered to determine behavior and understand provider/scheme at issue - Utilize appropriate documentation and tracking controls in the case tracking system to ensure compliance and auditability requirements are met - Collaborate with SIU Lead Investigator to apply knowledge of coding guidelines to determine validity of aberrances - Collaborate with a variety of external sources to identify current and emerging patterns and schemes related to FWA - Perform member and provider interviews, and review medical documentation as needed - Communicate with legal, Law Enforcement, clients and business partners as needed - Perform all other duties as assigned Qualifications - High School Diploma/GED and 5+ years of experience working in a FWA / SIU or Fraud investigations role OR Associate’s degree in Criminal Justice or experience in a related field - Certified Professional Coder (CPC) - 2+ years of experience within the health insurance claims industry - 1+ years of knowledge and/or experience with medical/behavioral health codes and service delivery - Intermediate level of proficiency in Microsoft Excel (pivot tables and macros) and Word (creating, editing, and saving documents) Requirements - 2+ years of experience working with law enforcement or legal entities or 3+ years of investigative experience with fraud investigations - Professional certification as a Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), or similar - Familiar with CPT code terminology - Experience with computer research - Experience with regulatory compliance - Experience with data analysis as it relates to financial recovery/settlements Benefits - Comprehensive benefits package - Incentive and recognition programs - Equity stock purchase - 401k contribution (all benefits are subject to eligibility requirements) Company Description 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.

Role Description Onapsis is looking for a proactive and detail-oriented Legal Operations Analyst to join its legal department. The ideal candidate will contribute to the preparation and review of legal documents, provide insightful analysis to support legal decision-making, and optimize legal processes, data management, and reporting, ensuring accuracy and efficiency. Reporting to the Director Legal Operations & Corporate Counsel, the Sr. Legal Analyst will: - Draft, review and negotiate global supplier agreements, collaborating with internal stakeholders from different departments. - Support contract executions in a timely method with appropriate legal oversight to ensure compliance with company standards. - Draft, review and negotiate many types of commercial technology contracts with a diverse set of customers, following the company’s standards, such as NDA’s, SOW’s, Software Order Forms, Master Software License Agreements, Master Services Agreements for On-Prem or SaaS solutions, etc. - Draft, review and negotiate many types of commercial technology contracts with a diverse set of partners, such as Managed Services Security Agreements, Reseller Agreements, Subcontractor Agreements, etc. - Coordinate redlines and negotiation strategies with legal and other stakeholders. - Negotiate legal and business terms and collaborate, coordinate and explain risks and implications of contract terms to Legal, the business, and other stakeholders. - Complete gap analysis, review, redline and understand contract language, risks and implications of such language. - Defend legal terms on standard internal templates, agreements and third-party paper where necessary. - Collaborate with Onapsis Legal in the development, oversight and maintenance of relevant contract templates in our CLM Tool and legal database and fallback checklists. - Collaborate with internal stakeholders (e.g., HR, Finance, Product, Infosec) to ensure legal matters are aligned with the company’s objectives. - Maintain and optimize the contract database within the CLM tool and legal database, ensuring accurate storage and retrieval of all company commercial agreements electronically. - Maintain detailed logs of all commercial contracts and legal requests, generating weekly, monthly, and quarterly reports on contract status and key terms. - Conduct legal risk assessments of customer contracts, identifying potential compliance issues, liability risks, and deviations from company policy and submit them to internal decision-makers for discussion and resolution. - Track contract status and lifecycle, working collaboratively with internal stakeholders to continuously improve company contract processes and reduce turnaround times. - Participate in continuous improvement projects to enhance the efficiency and effectiveness of Legal Operations, including the implementation of new workflows. - Assist in global corporate matters of the group, including subsidiary management and international regulatory compliance. - Assist in the administration of the global insurance program, including policy renewals, claims processing, and risk assessments. - Assist in the administration and development of the company’s patents and trademarks global portfolio. Qualifications - Bachelor’s degree in law. - 5-7 years of relevant work experience. - Business fluent in English with concise verbal and written communication skills is essential. - Prior experience drafting, reviewing, and negotiating IT, technology product and/or services agreements is a must. - Must be detail oriented and have strong organizational skills. - Ability to handle multiple tasks simultaneously. - Ability to prioritize; must be responsible and conscientious. - Ability to work under pressure to meet specific deadlines. - Ability to work independently and in a team environment. - Dedication to quality and reliability in all work tasks. - Demonstrate autonomy, take ownership, and drive tasks to closure. - Team player with a sense of humor. - Strong computer skills (e.g., Google Workspace, Microsoft Word/Excel, etc.). Experience with a CLM tool, Slack and Salesforce nice-to-have. Location - This is a remote role, candidates must be based in Buenos Aires, Argentina. Benefits - A unique culture of high achievement and teamwork. - Supportive and humble colleagues. - OSDE Medical Insurance. - Unlimited Paid Time Off. - Onaversary Holiday.