Job Description

At UnitedHealthcare, we\xe2\x80\x99re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life\'s best work.(sm)

We\xe2\x80\x99re seeking a flexible self-starter with an investigative nature to fill the position of Provider Data Consultant with the UnitedHealthcare Strategic Platform (USP) Provider Operations Support team within this highly visible program. In this role, you will enjoy a tremendous opportunity for growth, along with exposure to many areas of the company. USP is a large scale, multiple year initiative that will create the technology and process solutions that allow UHC to migrate to a common platform, improving speed to market on new products, networks, and innovations.

This is a complex, fast-paced, matrixed environment with a lot of moving parts; and you will work with the brightest minds in the business, digging deep to find the solutions to help people live healthier lives. You will be responsible for analyzing and configuring, Division of Financial Responsibility (DOFR), Division of Administrative Responsibility (DOAR), and Division of Medical Responsibility (DOMR) which are all integral parts of a Capitated Risk agreement. You will also provide support in resolving any issues regarding system set up. that cross-functional teams face with implementation of product features in collaboration with business and IT stakeholders. Additionally, you will be responsible for providing support, troubleshooting, and overseeing provider issues post-deployment, recommending solutions as required, with a focus on the quality of our data and our processes.

You will work closely with all USP Provider Teams, Claims Operations, Healthcare Economics, and others to discover, understand, and drive end to end solutions to deliver continual operational efficiencies. This will include, but not limited to, leading the creation of formal problem statements, root cause analysis, and push issue owners to implement long term solutions. You will utilize your solid communication, data trending and analysis skills to facilitate collaborative sessions, presenting findings and resolutions to multiple levels of stakeholders and leadership.

You\xe2\x80\x99ll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Work with IT to ensure all necessary fields are in Cirrus that will support risk agreements
• Analyze and Configure the Division of Financial Responsibility (DOFR) schedule into the Cirrus Platform
• Configure the Division of Financial Responsibility (DOFR) schedule
• Provide support on handling incidents relating to claims and provider load issues
• Regularly analyze data reports to locate and resolve inaccuracies
• Accurately collect data for various types of business reports
• Using solid written and verbal communication skills, effectively relate data to coworkers and leaders
• Utilizing excellent critical thinking skills to help solve business problems and make decisions
• Detail oriented work, as it could impact results
• Develop data driven reports with your analytical skills
• Monitor team metrics for trending issues to ensure we are meeting our targets
• Lead issue resolution and root cause analysis discussions with subject matter experts, owners, and leaders

You\xe2\x80\x99ll 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:

• 3+ years of experience in the health care industry
• 2+ years of experience working with Capitated Contracts, interpreting DOFR, including configuration and/or contract loading
• 2+ years of claims/data entry experience
• 2+ experience managing cross functional projects and making presentations
• Intermediate level of proficiency with MS Excel
• Intermediate level of proficiency in tracking, trending and reporting on metrics
• Proficiency in PowerPoint Data

Preferred Qualifications:

• Undergraduate degree or equivalent work experience
• 4+ years of experience working with Capitated Contracts, interpreting DOFR, including configuration and/or contract loading
• Large-scale platform implementation or migration experience
• System knowledge of NICE, NDB, USP
• Knowledge of data structures within a health plan configuration system (e.g. NDB)
• Agile lifecycle/methodology
• Proven ability to work with global team members
• Proven resilient and resourceful, you maintain calm, focus, and persevere under pressure
• Demonstrated accountability, you demonstrate energy for what needs to be done, acting on priorities, and overcome challenges
• Proven achievement drive, you volunteer for and seek out opportunities to learn and grow
• Proven growth mindset, you get energized by the new, different, and unique; you embrace change
• Demonstrated ability to influencing others, you create a clear and persuasive value proposition, and understand the audience
• Demonstrated ability to organizes by thinking through the best sequence of steps necessary to make the most efficient use of time and resources
• Proven solving problems, you define, prioritize, and analyze problems for action; later, debriefing and strategizing for future accountability
• Proven ability to work effectively with minor supervision
• Proven ability to work with global team members
• Demonstrated ability to clearly articulate (both verbal and written) project status and issue management

Careers with UnitedHealthcare. Work with a Fortune 5 organization that\xe2\x80\x99s serving millions of people as we transform health care with bold ideas. Bring your energy for driving change for the better. Help us improve health access and outcomes for everyone, as we work to advance health equity, connecting people with the care they need to feel their best. As an industry leader, our commitment to improving lives is second to none.

California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $67,800 to $133,100. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you\xe2\x80\x99ll find a far-reaching choice of benefits and incentives.

*All employees working remotely will be required to adhere to UnitedHealth Group\xe2\x80\x99s Telecommuter Policy

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone\xe2\x80\x93of every race, gender, sexuality, age, location and income\xe2\x80\x93deserves 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 \xe2\x80\x94 an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

UnitedHealth Group