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.
The Power BI Developer will support Claims Payment Integrity (PI) initiatives by designing, developing, and optimizing highquality BI dashboards, reports, and selfservice analytics products. The role will transform complex claims, provider, and membership datasets into actionable insights, enabling PI, audit, recovery, actuarial, and finance teams to make datadriven decisions. Work will be performed primarily in Power BI, leveraging Databricksbased analytical datasets in a governed enterprise environment.
Primary Responsibilities:
- Dashboard & Report Development
- Design, build, and maintain Power BI dashboards that deliver insights on claims performance, provider behavior, pricing patterns, and PI use cases
- Create intuitive data visualizations, KPIs, drilldowns, and interactive reporting experiences for business stakeholders
- Develop reusable semantic models, measures, and calculation logic using DAX
- Build tabular data models optimized for performance, refresh speed, and governance
- Knowledge of the latest AI advancements in the BI technological landscape
- Data Modeling & Integration
- Work with Databricks-engineered analytical datasets (Delta tables, curated layers) to create BI-ready data structures
- Apply bestpractice dimensional modeling concepts (star schemas, fact/dimension separation) to support complex PI reporting
- Optimize DirectQuery, Import, Hybrid models based on performance requirements and dataset size
- Business Collaboration
- Partner with PI SMEs, actuarial analysts, recovery teams, and product owners to translate reporting requirements into BI solutions
- Conduct requirement workshops, wireframe visual concepts, and iterate dashboards based on stakeholder feedback
- Ensure KPI definitions, business rules, and visualizations align with enterprise standards
- Governance, Quality & Operations
- Implement rowlevel security (RLS), workspace governance, and PHIcompliant practices
- Establish automated data refreshes, performance tuning, and dashboard usage monitoring
- Maintain documentation covering DAX logic, data sources, metric definitions, and refresh schedules
- Participate in Agile ceremonies, sprint reviews, and backlog refinement
- 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:
- Bachelor's degree
- 5+ years of BI/Reporting experience in healthcare
- Solid handson experience with Power BI Desktop, Power BI Service, DAX, Power Query (M), and tabular modeling
- Experience working with claims, provider, and membership data
- Knowledge of latest AI advancements in BI tech landscape
- Proven ability to connect Power BI to Databricks SQL endpoints, Delta tables, and enterprise lakehouse environments
- Proven solid SQL skills for data profiling, transformations, and KPI logic development
Preferred Qualifications:
- Experience with PIspecific reporting (duplicate claims, pricing anomalies, eligibility issues)
- Experience building enterprise semantic layers or selfservice BI frameworks
- Familiarity with Call Center datasets (member & provider calls), Provider RCM data, and EHR/clinical datasets for multi-source analytic integration
- Knowledge of Databricks SQL, Unity Catalog, and governed analytics environments
- Proven exposure to actuarial reporting, forecasting dashboards, or costofcare analytics
