Provider Data Process and Support Subject-Matter-Expert - Telecommute

Company: UnitedHealth Group
Location: San Antonio
Posted on: June 24, 2022

Job Description:

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

The Optum Care Provider Data Process and Support Subject-Matter-Expert (SME) is responsible for varying support functions for our Provider Data Management (PDM) team. - Primary duties are centered around fielding process-related questions, researching claim or provider set-up issues, performing root-cause analysis, as well as recommending and implementing remediation steps for issue prevention and/or reduction. - This individual makes recommendations related to process improvements to gain on efficiency or improve upon quality. - Provider Data Process & Support SME's communicate and/or present in meetings of varying size, audience and/or format.

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

Primary Responsibilities:

Educate or assist PDM team or business partners in provider updates or questions related to the update process

Research provider issues & escalations, perform 5 Why Root-Cause Analysis, document results and share with internal business partners

Build and implement resolution steps based upon issues discovered or brought to team attention

Ensure adherence to quality measures and timeliness, as well as promote adherence across teams

Be accountable for the daily activities of business support, apply proper prioritization to tasks, communicate roadblocks or issues, and adhere to deadlines or deliverables

Work independently with little direction, while collaborating and communicating, as needed

Attend team meetings, 1:1's, focus groups & ad-hoc meetings

Coach provider data team members on quality errors and proper procedures

Assist in training of new or cross-training members of the Provider Data Management or Provider Data Process Support & Experience team

Consistently maintain process documentation with current procedures

Assist in manual reporting updates

Provide insight to implementations teams on provider data processes, make recommendations and communicate back to team any impacts, as well as new or upcoming changes for new business

Assist in promoting the use of appropriate tools / reference material (including policies & procedures, claim workflow documents, file documentation)

Address and support the needs / requests of business partners and ensure team is doing the same (lead by example)

Demonstrate role model behavior regarding the core values of Integrity, Compassion, Relationships, Innovation, Performance

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:

High school diploma or GED

1+ years of provider data related experience

Proficiency with Microsoft basic applications (Outlook, Excel, Sharepoint, PowerPoint, etc.)

6+ months Facets experience

Preferred Qualifications:

Claims experience

Documentation & process flow experience

Trainer experience

5 Why Root-Cause Analysis experience

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 at OptumCare. We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen. Together we're creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us all. Join us and learn why there is no better place to do your life's best work.(sm)

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

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.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

Keywords: UnitedHealth Group, San Antonio , Provider Data Process and Support Subject-Matter-Expert - Telecommute, Other , San Antonio, Texas