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)
The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This specialist role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. Your expertise in provider networks can help us build in the next phase of evolution. In this role, you'll use your expertise and analytical skills to help determine how clinical providers group up by specialty and service line. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 5 leader.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
- Works closely with all internal and external partners to ensure effective and appropriate regulatory product design, monitoring, and revisions when appropriate
- Recommends changes, training and process improvements to prevent future errors
- Perform analysis, strategy development, and implementation
- Support regulatory and out-of-network daily initiatives
- Obtain, validate and analyze data as needed
- Conducts research on errors and works through appropriate channels for correction
- Establishes and cultivates business relationships with associated partners
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.
- Undergraduate degree or 4+ years of equivalent work experience
- 2+ years of experience with tracking and claim investigation
- 2+ years of experience planning projects, building relationships, and working with data sets
- Proficiency in Microsoft Office suite
- 2+ years of experience with claims processing or resolution and medical coding
- 1+ years of experience working in regulatory, vendor management, or out of network environment
- Customer Service, Claims, or Provider Relations Experience
- Excellent time management, organizational, and prioritization skills and ability to balance multiple priorities
- Excellent verbal and written communication skills
- Ability to convey complex information to others and make it more easily understood
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination 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 UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)
Colorado, Connecticut or Nevada Residents Only: The hourly range for Colorado residents is $20.77 to $36.88. The hourly range for Connecticut / Nevada residents is $22.93 to $40.58. 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.
Job Keywords: Network Program Specialist, Claims, Investigation, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote