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Job Details

UnitedHealth Group

Government Program Consultant - Telecommute (must be in middle TN) (109751777)

Government and Military

Government Affairs



Brentwood, Tennessee, United States

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)

There comes a point when you're ready to take off the training wheels and start guiding others. If that's where you are today, let's talk about where you can be tomorrow with our leading, global health care organization. UnitedHealth Group is driving ever higher levels of sophistication in how provider networks are composed and compensated. Everything is open to new ideas and innovation. Here's where you come in. Your expertise in provider networks can help us build in the next phase of evolution. In this role, you'll use your knowledge and analytical skills to help manage assigned providers in our Tennessee TennCare value based contracted programs. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 5 leader.

If you are located in Middle Tennessee consists of cities such as Clarksville, Nashville, Murfreesboro, Columbia, Lebanon, etc.), you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Manage value based TennCare programs (Episodes of Care, Journey and BESMART) for assigned provider territory in Middle Tennessee
  • Drive program design and implementation to improve quality and affordability through improvements in appropriateness and effectiveness
  • Obtain, validate, and analyze data as it pertains to the VBC (Value Based Contracting) programs in Tennessee
  • Recommend utilization of UnitedHealthcare tools and programs to assist network providers to have better program and patient outcomes
  • Integrate UHC Point of Care Assist (POCA) tool into existing VBC programs for real time patient management
  • Serve as a key resource on complex and/or critical issues
  • Attend, support and possibly present at various provider education events, conferences, and Provider Information Expos
  • Assist the Southeast Region (LA, MS, TN, NC) with ACO Medicaid annual contract renewal

Must be physically located in Middle Tennessee (Middle Tennessee consists of cities such as Clarksville, Nashville, Murfreesboro, Columbia, Lebanon, etc.)

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.

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+ yeras of experience in claims processing and provider data maintenance
  • 3+ yeras of demonstrated provider relations experience in working with physicians and facility/hospital providers
  • 3+ yeras of experience in understanding how claims impact VBC programs
  • 3+ yeras of experience working with value based contracted programs
  • Solid knowledge of business processes
  • Physically located in Middle Tennessee (Middle Tennessee consists of cities such as Clarksville, Nashville, Murfreesboro, Columbia, Lebanon, etc.)
  • 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 Qualifcations:

  • Project management
  • Solid provider relationship building and maintenance experience preferably with providers in Middle Tennessee
  • Solid time management skills, ability to adapt to a fast paced and changing work environment
  • Ability to work closely with external partners and internal partners to address provider issues that arise

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 salary range for Colorado residents is $66,100 to $118,300. The salary range for Connecticut / Nevada residents is $72,800 to $129,900. 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.