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
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