Marketcares Senior Provider Data Analyst - Remote

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 and start doing your life's best work.(sm)

marketCARES Loading Analysts are responsible for processing various types of submitted load requests related to an assigned market or region within the provider network database (NDB), NICE and/or research related to CLM. The loaders make informed decisions through following SOP and Job Aid Guidelines to review submissions and synthesize various supporting documents (emails, spreadsheets, faxes, previous communications) to deliver quality results and are responsible for properly maintaining the provider data housed in our core systems to allow for proper claim payment and member/provider directory information. They complete items that are simple to moderately complex and either escalated and non-escalated in nature and work closely with internal business partners to ensure timely completion.

Positions in this function are responsible for following standard operating procedures supporting system and platform loading (ie: NDB, NICE, IMPACT, CSP Facets, PhyCon, and CLM) and potentially contract and demographic research to determine what needs to be modified in the system, as well as secondary platform loading based on the submission and subsequent research. They are responsible for overall provider Contractual and Demographic loading and processing using various databases. This may include auditing contractual and demographic loads for adherence to quality measures and reporting standards, and/or running PreDict Tool to ensure accuracy.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Responsible for representing provider business operations area on company IT projects
• Serve as a key resource on complex and / or critical issues
• Solve complex problems and develop innovative solutions
• Performs Provider PICK edits and inventory review and resolution.
• Conduct audits and provide feedback to reduce errors and improve processes and performance, maintaining current provider data to ensure the quality of the network
• Prioritize data quality initiatives with regard to numbers of records remediated, amount of investment required, and importance of data
• Anticipate customer needs and proactively develop solutions to meet them
• Initiate co-operation across UHG to facilitate the improvement of provider data by multiple stakeholders

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:

• 3+ years of equivalent experience
• Proven solid analytical and problem-solving skills, able to read between the lines
• Demonstrated excellent written and verbal communication skills, including the ability to communicate at all levels including senior leadership and provider groups
• Proficiency with multiple auditing tools, such as Examiner, Hive, NDAR, AMAARDI reporting
• Advanced proficiency with Excel, including use of filter, remove duplicates, text to columns, and basic formulas, etc
• Demonstrated skills in manipulating data, attention to detail, strong organizational skills
• Advanced proficiency in NDB provider data loading for delegated and non-delegated providers
• Proficiency with all UHC provider data systems (NDB, PhyCon, CLM) and claims platforms (UNET, PULSE, NICE, COSMOS, CSP Facets) used in the region
• Intermediate level of proficiency with all physician contract reimbursement methodologies

Preferred Qualifications:

• Proven solid organizational and interpersonal skills in a matrixed environment
• Demonstrated ability to self-manager and multitask in a fast-paced production environment where quality is important
• Proven exceptional skills in manipulating data, attention to detail, solid organizational skills

Careers with UnitedHealthcare. Work with a Fortune 5 organization that’s serving millions of people as we transform health care with bold ideas. Bring your energy for driving change for the better. Help us improve health access and outcomes for everyone, as we work to advance health equity, connecting people with the care they need to feel their best. As an industry leader, our commitment to improving lives is second to none.

California, Colorado, Connecticut, Nevada, New York, Rhode Island, or Washington Residents Only: The hourly range for California, Colorado, Connecticut, Nevada, New York, Rhode Island or Washington residents is $27.07 to $53.08. 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 employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

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.