Sr Provider Configuration Analyst - Telecommute

Company: UnitedHealth Group
Location: Los Angeles
Posted on: June 26, 2022

Job Description:

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing -your life's best work.(sm) - The Facets Provider Pricing Capitation Analyst will be responsible for reading, interpreting, and building contracts for contracted providers who are reimbursed according to a capitation method. They will also be accountable for reviewing the work of others and providing feedback to remediate configuration anomalies identified. Capitation analyst will execute programs to evaluate preliminary month-end reporting statistics and make any adjustments required to properly administer contractual requirements. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. - -Primary Responsibilities: -

• Read and interpret complex professional provider contracts
• Conduct Audits in Partnership with the Internal Teams
• Create reports and analyses using Facets data to validate pre and post configuration changes made by self or others
• Conducts Configuration Analysis (by reviewing configuration set-up and identifying root cause of findings)
• Collaborate with Claim Ops to Validate Accuracy of Claims Payments to Capitated Providers
• Collaborate with Eligibility to Validate Accuracy of Provider Empanelment
• Identify Process Improvement Opportunities (to improve accuracy and timeliness)
• Assists with Internal Quality Control Points and Unit Testing
• Serves as SME to assist Provider Configuration Team
• Participates in Configuration Requirement Gatherings for New Business and/or Processes 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:
  • High school diploma or GED
  • 3+ years of Provider Capitation experience
  • 3+ years of Facets experience in Provider Configuration
  • 3+ years of Network Management Contracting to include knowledge of business processes that impact capitation contract loading and auditing
  • Self-directed individual with a proven track record of strong organizational skills and ability to adapt quickly to change
  • Strong communication skills to clearly and concisely translate complex or technical information for diverse internal audiences
  • Proven ability to manage productivity and efficiency in order to visualize and achieve set goals for delivery of contracts for installation
  • Intermediate level of proficiency with Microsoft Word / Excel / Outlook / SharePoint
  • Ability to conduct data analysis using MS Access or SQL to support business decisions related to capitation setup and pricing configuration
  • Strong customer focus with proven ability to anticipate, understand, and meet the needs of internal and external customers Preferred Qualifications:
    • Undergraduate degree in business or healthcare preferred To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment - Careers at OptumCare. -We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen. Together we're creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us all. Join us and learn why there is no better place to do -your life's best work.(sm) - - OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians. - *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. - Colorado Residents Only: -The hourly range for Colorado residents is $31.78 to $70.63 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'll find a far-reaching choice of benefits and incentives. Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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. - OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment - -

Keywords: UnitedHealth Group, Los Angeles , Sr Provider Configuration Analyst - Telecommute, Professions , Los Angeles, California