At UnitedHealthcare, we’re 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 to start Caring. Connecting. Growing together.
This role is a hybrid between a Roster Manager and an ACO Data Analyst, we manage the value-based agreement for both UHN and Optum Care as well as other special agreements, like Doctors Plan and Select Colorado.
Our Team Manages the roster or list of providers deemed to be part of the agreement, we maintain both the del code and the network number and in some cases the entity ID for the group. We perform weekly audits to ensure data remains clean and accurate, we have specialized reporting to help us perform this audit. Our team will either be assigned to a group to manage one specific line of business for the VBC agreement or a state to manage the VBC for a list of multiple tins.
The goal is to keep the data clean which means we must do a lot of root cause analysis, provide education to both the group and our internal partners, ensure all loading instructions are accurate and partner with not only the group but with our internal partners like Network, Finance and Benefits and Enrollment to name a few.
Each group and state are unique based on the agreement and the expectation, there is a lot of out of the box thinking done and changing gears.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Anticipate customer needs and proactively develop solutions to meet them
House the main roster as source of truth
Keep track of all updates requested as well as the status of those updates
Monitor roster for any fall out of expected updates as per contract
Liaison between external group and internal partners
Direct loading and submissions to PhyCon
Titan submissions for automation
Monitor and manage all clarifications from PhyCon submissions
Partnerships & Interactions:
Network Management
Roster Management
ACO Data Analyst
External Group
Automation Team
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:
4+ years of experience with UHC provider data and related claim systems with full understanding of how provider data impacts both provider and member experience
3+ years of advanced knowledge in Contract Language
3+ years of direct Loading experience in both NICE & NDB
In depth understanding of contractual language or ability to understand contract verbiage
Basic understanding of Value Based Agreements
Advanced or intermediate knowledge of Excel
Proven excellent Communication Skills, both verbal and written
Presently employed within UHC Provider Data Operations (PDO)
Preferred Qualifications:
Experience with ACOs
Experience with Value Based Contracts and Medicare Incentive Agreements
Experience with UHN Reporting, Examiner, IMPACT
Experience with Primary Care Physicians and membership assignment
Experience with root cause analysis
Proficiency in MS Access and PowerPoint
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
The salary range for this role is $71,600 to $140,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.
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.
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
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