Provider Data Analyst - Telecommute

  • Houston Tx
  • 01/26/2023

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

Position in this function administers the contractual and demographic data setup for the provider network (physicians, provider groups, IPA/PHOs, etc.) to ensure accurate claims payment and accurate directory depiction in accordance with our contractual agreement with the providers.

Job Components (List the major job responsibilities, accountabilities, and key responsibilities in order of priority.  Also include any relevant scope measures as they pertain to the duties listed below):

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

Primary Responsibilities:

  • Internally facing - maintaining the contract administration, implementation, and maintenance of provider contract terms and data which impacts claim payment or directory depiction
  • Positions in this function are responsible for various activities related to the provider network database(s) which may include any or all the following: database(s) maintenance, reporting, and extracting data for various reports and analyses
  • Identify process improvements
  • Maintains standards for database(s) integrity and quality assurance, and coordinates corrective activities to clean database(s) and retain users
  • Handles complex and difficult transactions in the region, with limited guidance as needed
  • Manages communication processes with other departments regarding clarifying questions for database(s) updates
  • Maintains current provider data to ensure the quality of the network
  • Researches issues surrounding the accurate and timely loading of contractual and demographic data
  • Uses pertinent data and facts to identify and solve a range of problems within area of expertise
  • Investigates non-standard requests and problems, with some assistance from others
  • Works exclusively within a specific knowledge area
  • Prioritizes and organizes own work to meet deadlines
  • Provides explanations and information to others on topics within area of expertise
  • Streamlines communication between UHN and PDO regarding contract/demographic updates by consistently following processes to eliminate handoffs and rework
  • Ensures high quality data submissions 
  • Reduces contract/demographic errors that affect members 

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:

  • Proficiency with Excel, including use of filter, remove duplicates, text to columns, and basic formulas, etc. 
  • Proficiency with NDB and CLM 

Preferred Qualifications: 

  • Undergraduate degree and/or 2+ years of equivalent experience
  • Proficiency with UHC provider claims platforms (UNET, PULSE, NICE, CSP Facets
  • Exceptional skills in manipulating data, attention to detail, solid organizational skills

Essential Competencies and Critical CLL Practices for High Performers 

  • Competency: Communication and Collaboration

    • Behavioral Anchors:

      • Respond timely to emails or inquiries, within 48 hours if possible, and check to ensure the message was successful and effective
      • Plan and organize all communication and be mindful to follow proper escalation channels of communication
      • Leverage your talents and expertise and the talent and expertise of others to arrive at the best solution.
      • Participate in meetings and share knowledge, suggestions and best practices
      • Keep Leadership and Business Partners updated on any roadblock or challenge
      • Look for opportunities to collaborate and build networks and relationships before they are needed
      • Send internal clarifications to Network Account Managers and/or Provider Advocates only when necessary and respond timely and effectively to any clarification request sent to you
  • Competency: Inventory and Time Management

    • Behavioral anchors: 

      • Keep distractions at a minimum and ensure all work items are processed and prioritized efficiently and timely to guarantee metrics and turnaround times are met
      • Utilize all available resources and critical thinking skills to do your job before requesting assistance from others
      • Monitor and evaluate all available resource use and make any needed adjustments
      • Show commitment to high quality results through use of time, resources and work effort
      • Be thorough and action oriented in pursuing quality results by collaborating with others and by working across departmental boundaries
      • Demonstrate understanding of applicable products and contract terms for different lines of business (e.g., Employer and Individual, Medicare and Retirement, Community and State)
      • Provide timely review of all work items when needed
      • Offer assistance to team members if inventory increases or in order to accomplish more in less time.
  • Competency: Leading Myself

    • Behavioral anchors: 

      • Be accountable for yourself, your work and your own interactions
      • Be able to dig deeply and evaluate information to uncover the root cause of an issue in order to take decisive action
      • Pursue opportunities to become more self-aware
      • Seek feedback and address feedback positively, using it to enrich your knowledge and future effectiveness
      • Conduct yourself in a positive manner and demonstrate energy for what needs to be done to overcome challenges
      • Demonstrate diversity awareness
      • Stick to tasks and keep others informed of your progress
      • Use available resources designed for the task at hand in order to get work done timely, efficiently and effectively
      • Show compassion to improve customer experiences
      • Deploy your best self to achieve goals and objectives and to avoid distractions to remain focused
      • Be flexible and adaptive when faced with change
      • Ensure the required Learning and Educational Courses are completed in a timely manner
      • Ensure timely and accurate entry of all time worked
      • Achieve a sustainable work-life balance
  • Critical CLL Practice: Be Accountable

    • Be positive and show energy for what needs to be done and for overcoming obstacles and challenges.
    • Organize work tasks according to business priorities
    • Be able to minimize distractions and maintain focus
    • Act on priorities and stick to tasks
    • Know the turnaround time for specific work tasks
    • Keep others informed of progress
    • Critical CLL Practice: Communicate With Others
    • Know the importance of keeping people informed
    • Plan and organize messages and communication
    • Separate the nice to know from the must know
    • Get your message across timely, effectively, and efficiently
    • Ensure your message was successful
  • Critical CLL Practice: Serving Customers

    • Know your customers
    • Build a good network of contacts and relationships to help determine your customer’s expectations
    • Build trust and respect with customers and deliver a standard that meets/exceeds expectations
    • Gather feedback regularly and use feedback to improve your processes to better serve customers
    • Critical CLL Practice: Being Coachable
    • Be open and positive to feedback and use it constructively
    • Check often to ensure success and understanding with feedback
    • Be calm and appreciative when being coached
  • Critical CLL Practice: Solving Problems

    • Be proactive by anticipating potential problems
    • Collect information on the problem in order to define, prioritize and analyze the problem for possible action
    • Assess and implement appropriate decision strategy
    • Evaluate and report on solutions to problems
    • Debrief possible solutions and decision strategies for reasons of accountability and learning for future action

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 with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)

Colorado, Connecticut or Nevada Residents Only: The hourly range for Colorado residents is $21.68 to $38.56. The hourly range for Connecticut / Nevada residents is $23.94 to $42.40. 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.

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.