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Job Details

UnitedHealth Group

Manager Provider Data - Remote


Nurse Manager



Richardson, Texas, 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)

As the Manager over the team that facilitates the installation of provider rate configuration for three Commercial claim platforms, this position is responsible for serving as a Trusted Advisor to various internal teams (ex. Network Management, Provider Operations, Claim Operations, IT) to ensure timely and accurate installation of claim pricing configuration. This role is critical to driving Consumer and Provider experience by enabling accurate and timely claims adjudication.

This position is responsible for leading a team of analysts, who are responsible for: 1) database maintenance, 2) reporting, 3) providing support as Subject Matter Experts for configuration & installation of required table data as well as 4) initiating database improvement through participation in business requirement gathering for technology projects impacting rate installation and claim pricing. These efforts support strategic growth objectives, regulatory compliance as well as claim rework avoidance / reduction.

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

Primary Responsibilities:

  • Management of Technical Project Support team within Technical Support Services: Sets team direction, resolves problems, and provides guidance to members of own team
  • Coach/Mentor staff regarding operational efficiency/improvements of provider contract loading & table configuration through motivation and inspiration toward innovation, automation & collaboration
  • Perform all required administrative duties for Leaders of people (Ex. Provide & monitor MBO (Manage by Objectives) data, Setting goals & objects, Performance Evaluations, CLL (Common Language of Leadership) Development, routine 1:1’s with team members and others, team calls, back-up for other Leader peers, etc.)
  • Influences or provides input to forecasting and planning activities
  • Review data prepared by others and provide feedback
  • Adapts departmental plans and priorities to address business and operational challenges
  • Proactive awareness of product, service, or process decisions that will have impact to multiple groups of employees and/or customers (internal or external) - understand up and downstream impacts and make recommendations for improvement - remove barriers
  • Anticipates customer needs through collaboration and proactively address gaps and develop solutions to meet them
  • Receive data from multiple inbound sources (e.g., paper contracts, spreadsheets, email, claim, etc.) and have ability to translate to identify trends, patterns, or risks into actionable tasks
  • May lead functional or segment teams or projects
  • Provide input/suggestions into database or system design based on process, information, or regulation changes, or client
  • Develop and/or contribute to rules and procedures to meet business or regulatory requirements -Maintain current knowledge of business strategies, rules, and procedures (e.g., attend training) -Demonstrate an understanding of and apply business strategies, rules, and procedures as appropriate. Lead or participate in applicable projects related to business rules and procedure to ensure adherence to policy & procedure as well as legal & regulatory requirements
  • Ensure that data and work processes conform to stated guidelines and regulations (i.e., through CMS, IRS, State DOI, Federal, HIPAA, etc.)
  • Understanding the impact of work is at the local & national level

Values Based Competencies:

  • Integrity Value: Act Ethically
    • Comply with applicable law, regulations, and policies
    • Demonstrate integrity
  • Compassion Value: Focus on Customers
    • Identify and exceed customer expectations
    • Improve the customer experience
  • Relationships Value - Act as a Team Player
    • Collaborate with others
    • Demonstrate diversity awareness
    • Learn and develop
  • Relationships Value - Communicate Effectively
    • Influence others
    • Listen actively
    • Speak and write clearly
  • Innovation Value - Support Change and Innovation
    • Contribute innovative ideas
    • Work effectively in a changing environment
  • Performance Value - Make Fact-Based Decisions
    • Apply business knowledge
    • Use sound judgment
  • Performance Value - Deliver Quality Results
    • Drive for results
    • Manage time effectively
    • Produce high-quality work

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 experience in the healthcare industry
  • 3+ years leading or mentoring/coach others; be the change and lead by example
  • 3+ years of experience with Network or Provider Operations
  • Experience with 1 or more of these UHC Core platforms: NDB, UNET/TOPS, ppoONE, NICE
  • Experience with Data Analytics & Provider configuration
  • Experienced in Microsoft suite of products
  • Occasional travel up to 25% – This position may require travel from time- to-time, but not on a regular basis. The travel may be for training or other work-related duties
  • Full COVID-19 vaccination is an essential job function 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. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifications:

  • Completed Agile Training
  • Experience analyzing claims
  • Experience reading and translating provider contracts
  • Experience managing operational processes or projects
  • Knowledge of or experience with UHC Core applications: PDP/PES, pODM, IMPACT, USP, etc.
  • Knowledge of or experience with Risk/Value Based Contracting methodologies including capitation, incentive programs, risk sharing, etc.
  • Excellent, demonstrated verbal and written communication to diverse audiences

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 $82,100 to $146,900. The salary range for Connecticut / Nevada residents is $90,500 to $161,600. 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.