Senior Provider Configuration Analyst - National Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Senior Provider Configuration Analyst will configure pricing into a Facets platform which uses Network pricing capabilities for Practitioners, Acute Care Hospitals, Critical Access Hospitals, Ambulatory Surgical Centers, Federally Qualified Heath Care (FQHCs), Rural Health Clinics, Dialysis, and Ancillary provider types. This role will also be accountable for reading, interpreting, and translating provider contracts (or other pricing documents) into configuration design templates to facilitate contract loading (by self or others). The role is also accountable for following documented job aides and policies and procedures required to complete basic-to-complex configuration designs; and to teach them how to perform detailed analysis required to resolve and remediate configuration discrepancies/disputes. Additionally, the Senior Provider Configuration Analyst is responsible for loading provider fee schedules; and they are accountable for extracting pricing data from Facets to evaluate configuration outcomes and for reviewing and resolving pended claims which are attributed to pricing setup.

This position is full-time. Employees are required to have flexibility to work during our normal business hours of 8:00am - 5:00pm local time. It may be necessary, given the business need, to work occasional overtime.

We offer weeks of on-the-job training. The hours of the training will be based on schedule or will be discussed on your first day of employment.

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

Primary Responsibilities:

• Reading and interpreting provider contracts, or other pricing artifacts, to complete provider configuration design templates.
• Loading provider contracts into Facets (using Facets or Network capabilities).
• Extracting and analyzing pricing data to help assess load accuracy and to resolve provider pricing inquiries and/or pended claims.
• Complete quality control measures to ensure accuracy of agreement build (Arch Review, testing outputs, etc.).
• Identify process improvement opportunities to improve accuracy and timeliness (i.e., automation, turn-around time, etc.).
• Work in partnership with the Contract Management Experts to conduct retrospective contract audit, which includes identifying configuration defects.
• Assist with the development and coaching for new Configuration Analysts.
• Manage assigned inventory to ensure timely contract load.
• Perform user acceptance testing on new/changed pricing tools.
• Serve as subject matter expert regarding configuration and/or Facets capabilities.
• Create proof of concept configuration designs for new pricing requirements.

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 / GED OR equivalent work experience
• Must be 18 years of age OR Older
• 3+ years of Provider Pricing Configuration on the Facets Platform, preferably with pricing experience using both core and Network functionality
• 3+ years of experience Reading, Interpreting, and Translating provider contracts for professional, facility and ancillary providers
• Intermediate level of proficiency with Microsoft Word / Excel / Outlook / SharePoint
• Self-directed individual with a proven track record of strong organizational skills and ability to adapt quickly to change
• Ability to have flexibility to work during our normal business hours of 8:00am - 5:00pm local time. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:

• Medicare, Medicaid & Commercial pricing experience
• Understanding of physician, facility and ancillary contract reimbursement methodology
• Communication skills to translate complex or technical information clearly and concisely for diverse internal audiences
• 5+ years of Physician, Facility, and Ancillary contract reimbursement methodology with Medicare products

Telecommuting Requirements:

• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

The hourly range for this role is $16.88 to $33.22 per hour based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.

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