Joshua Anderson

About Joshua Anderson

Director, AI/ML & Analytics | Payer Platform Modernization | Power BI • Azure • Touchless ClaimsI’m a healthcare technology executive driving platform modernization at scale. As Director at Optum (UnitedHealth Group), I lead engineering and analytics teams across AI/ML, cloud, and automation delivering enterprise-wide outcomes in claims processing, FWA analytics, and observability platforms. Core Expertise:Touchless Claims Adjudication (First Pass, Rework, Corrected Claims)AI/ML & Automation Strategy across 14+ platformsAzure Data Lakehouse: Databricks, Snowflake, Kafka, KubernetesPower BI productization & enterprise observabilitySG & A optimization and stakeholder reporting Business Impact:Enabling ~$116M in SG & A savings through AI, automation, and analyticsDelivering ~99% reduction in manual adjudicationDirecting large-scale platform strategies across payer and care deliveryWith 20+ years of experience across healthcare, finance, and digital operations, I align data strategy with enterprise goals improving affordability, accelerating digital transformation, and uncovering hidden revenue through measurable insights.

Experience

1. Director, Ai Ml, Analytics, and Automation

   Optum

   Jan 2019 — Present

   Lead enterprise data, analytics, and automation strategy across 14 payer platforms, driving paradigm shifts in claims processing, cybersecurity, and intelligent automation. Spearhead cross-functional teams in AI, Machine Learning, Power BI, and RPA delivering touchless claims adjudication and measurable business outcomes.Architect and oversee automated pipelines for 18M+ claims annually, representing $5B+ in billed charges; align to X12 standards across providers and members.Pioneer enterprise-grade analytics platforms integrated with OfficeAlly, TransUnion, Waystar, Optum, and Zirmed to support decision intelligence and reduce rework.Deliver executive and external stakeholder reporting and guidance, aligning data products with business and regulatory goals.Drive automation of 837Professional and Institution claim workflows to reduce manual intervention and ensure compliance.Expedite cybersecurity incident resolution and system availability across 14 virtualized servers, 175 endpoints, and 180 associates spanning 5 operational sites.Slash operational overhead by automating X12 file processing and optimizing firewall, Active Directory, and security controls.

Education

• Northern Illinois University

  Bachelor of Science - BS, Econometrics/Applied Mathematics

  1993 — 2003

Skills

• Word
• Program Management
• Process Scheduler
• Planning
• Contract Management
• Compliance
• Data Analysis
• Business Analysis
• Product Management
• Outlook
• Integration
• Microsoft Office
• Problem Solving
• Operations Management
• Strategic Planning
• Marketing
• Training
• Customer Satisfaction
• Powerpoint
• Microsoft Excel
• New Business Development
• Negotiation
• Scheduling
• Project Planning
• Performance Metrics
• Customer Relations
• Software Documentation
• Excel
• Contract Negotiations
• Software Project Management
• Project Management
• Customer Service
• Strategy
• E-Commerce
• Supervisory Skills
• Administration
• Budgets
• Healthcare
• Policy Analysis
• Business Intelligence