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 optimized. Ready to make a difference? Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together. This is an opportunity to truly challenge yourself. You'll work on many different aspects of Provider Networks in this role including manipulating data, working with provider groups, managing projects, educating providers and navigating any issues with other teams such as sales, consulting or clinical. Positions in this function are responsible for the successful program design, compliance with network requirements, network assessment and selection, and program/product implementation. This includes enterprise-wide Clinically Integrated Network teams that focus on specific clinical area Lines of Service (e.g., Cardiology, Women's Health, Oncology, etc.) to improve the quality and affordability through improvements in appropriateness and effectiveness. May perform network analysis and strategy development and implementation. Obtains data, verifies validity of data, and analyzes data as required. Analyzes network availability and access. May make recommendations regarding use, expansion, selection of networks for various products based on that analysis.

• Generally work is self-directed and not prescribed.
• Works with less structured, more complex issues.
• Serves as a resource to others.

You’ll enjoy the flexibility to work remotely

• from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Help develop enterprise-wide Clinically Integrated Network teams that focus on specific clinical areas/service lines such as oncology or cardiology
• Perform network analysis and strategy development and implementation
• 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
• Serve as a key resource on complex and/or critical issues

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:

• 5+ years of experience in claims processing, provider data maintenance, contracting or contract loading
• 5+ years of experience with claims systems
• 3+ years of experience with contract submission, validation and maintenance
• Demonstrated solid knowledge of business processes that impact facility/ancillary contact loading and auditing
• Demonstrated Proficiency with all facility/ancillary contract reimbursement methodologies

Preferred Qualifications:

• Project management experience
• All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. 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 help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives. UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Apply To This Job