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Edge Submissions Consultant - Remote

UnitedHealth Group

Company : UnitedHealth Group

Location : Nashville, TN

Posted Date : 15 October 2025

Job Details

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.

As an Edge Submissions Consultant, you will grow and develop as you conduct and manage the outcomes of various studies. You will be challenged to analyze, review, and forecast data for operational and business planning. As part of this elite team, you will be empowered to impact the health care system through the analysis and interpretation of data and presenting recommendations for business solutions.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Direct client facing support for ACA EDGE Submissions to HHS with end-to-end accountability of client data

  • Understand the entire EDGE submissions process and ensure to keep the client informed and provide guidance regarding Optum and HHS errors

  • Present analysis and interpretation for operational and business review and planning

  • Support short and long term operational/strategic business activities through analysis

  • Develop recommended business solutions through research and analysis of data and business process and implement when appropriate

  • Positions in this function conduct and manage outcomes of various studies that include analyzing, reviewing, forecasting, trending, and presenting information for operational and business planning

  • Support short and long term operational/strategic business activities - by developing, enhancing and maintaining operational information and models

  • Develop and implement effective/strategic business solutions through research and analysis of data and business processes

  • Generally work is self-directed and not prescribed

  • Works with less structured, more complex issues

  • Serves as a resource for others

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:

  • 2+ years of experience in EDGE Submissions

  • 2+ years in a client facing role

  • 1+ year of experience gathering requirements from the client/business and documenting

  • 1+ year of experience with process improvement, workflow, benchmarking and / or evaluation of business processes

  • Intermediate level of proficiency with PC based software programs and automated database management systems required (Excel, Access, PowerPoint)

  • Working knowledge of relational databases, database structures

Preferred Qualifications:

  • 837 claim format experience

  • Healthcare Claim processing or health care related data

  • Experience in an Agile work environment

  • Ability to communicate analysis including trends and opportunities to clients and the business in writing and verbally

  • Ability to problem solve including multiple priorities and research conflicting and/or inaccurate data

  • Ability to perform well under pressure and multitask with little to no direction

*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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.

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