Employer: UnitedHealth Group
This position includes focus of managing the Behavioral Health network in multiple states with emphasis on provider education and support, claims investigation, and contracting support. There is direct provider support through phone and email engagement, along with online meetings. Communication skills to address escalated issues and working with multiple partners is a must. Knowledge of behavioral claims, contracting processes, and provider types is preferred. This position obtains data, verifies validity of data and analyzes data as required.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Midwest States are Preferred.
Primary Responsibilities:
- Assess and interpret customer needs and requirements
- Identify solutions to nonstandard requests and problems
- Solve moderately complex problems and/or conducts moderately complex analyses
- Work with minimal guidance; seeks guidance on only the most complex tasks
- Translate concepts into practice
- Provide explanations and information to others on difficult issues
- Coach, provides feedback, and guide others
- Acts as a resource for others with less experience
- Provide support across regional teams and network contracting as needed
- Perform network analysis and strategy development
- Drive program design and implementation to improve quality and affordability through improvements in appropriateness and effectiveness
- Obtain, validate, and analyze data as you analyze network availability and access
- Recommend utilization or expansion of networks for various products
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:
- Undergraduate degree or equivalent work experience
- 3+ years of experience with network data management in a managed care environment
- 3+ years of experience in provider data analysis
- 3+ years of experience with claims processing or resolution and medical coding
- 2+ years of experience working with reporting tools and generating effective reports
- Full COVID-19 vaccination is an essential requirement of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance
Preferred Qualifications:
- 3+ years of experience with claims processing systems and provider data bases as well as claims system testing
- Project management experience
- Ability to convey complex information to others and make it more easily understood
Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $54,400 to $97,000. The salary range for Connecticut / Nevada residents is $60,000 to $106,700. 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.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.