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Senior Network Program Specialist/Data Analyst- Eden Prairie, MN

Eden Prairie, MN UnitedHealth Group

You know it. We know it. Change is sweeping through health care in ways that go beyond the basics covered in the news.  People like you and organizations like UnitedHealth Group are driving ever higher levels of sophistication in how provider networks are composed and compensated. Everything is open to new ideas and innovation. And a lot of the good stuff starts in roles like this. 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 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 6 leader. 


 


Primary Responsibilities:



  • Help develop enterprise-wide Clinically Integrated Network teams that focus on specific clinical areas/service lines such as oncology or cardiology

  • Perform network analysis and strategy development and implementation

  • Drive program design and implementation to improve quality and affordability through improvements in appropriateness and effectiveness

  • Obtain, validate and analyze data as you analyze network availability and access

  • Recommend utilization or expansion of networks for various products

  • Coach, provide feedback, and guide others

This is an opportunity that comes with great challenge. You’ll be focused on value-based contracting for a particular health plan along with supporting the leading efforts of the business.  This position will be focused on analysis, running reports, disbursement of checks to providers, organizing booklets or educational material and more.


Required Qualifications:



  • Undergraduate degree or equivalent work experience

  • 2+ years of experience with network data management in a managed care environment

  • 2+ years of experience in provider data analysis

  • 2+ years of experience with claims processing or resolution and medical coding

  • 2+ years experience working with reporting tools and generating effective reports

  • Ability to convey complex information to others and make it more easily understood

  • Intermediate proficiency with Excel

Preferred Qualifications:



  • 3+ years experience with claims processing systems and provider data bases as well as claims system testing

  • Project management experience

  • Experience with Salesforce

Building diverse, high quality provider networks is creating greater access to health care and improving the lives of millions.  Join us.  Learn more about how you can start doing your life’s best work.(sm)



Careers with Optum. Here’s the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world’s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life’s best work.(sm)


 


 


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: Managed Care, health care, Network Program Specialist, network requirements, network assessment, network selection, network data management, provider data analysis, medical claims, claims processing, claims resolution, medical coding, project management, Eden Prairie, MN, Minnesota

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