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

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us and start doing your life’s best work.SM

This position will lead effort in improving end to end Capitated Delegated encounter accuracy, timeliness, and completeness. The role provides technical support for outstanding issues identified and proactively seeks out issues not identified. Scope includes reporting and analysis, initiating and directing project and providing technical knowledge sharing and consulting you will partner with teams across the organization to gather information and provide consultation to leadership. This position will be responsible for partnering closely with our delegated provider partners as well as with internal teams to resolve and prevent issues related to key CapDel operational processes.

This will improve the care provider experience by reducing the administrative burden that the issues place on both UHC and the delegated provider. This position will utilize their project management and analytical skills as well as extensive knowledge of the business and the business process to implement this operational infrastructure. This position requires the ability to act independently to lead and diagnose process improvement opportunities as well as the ability to drive complex issues to resolution with minimal supervision.

This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am – 5:00pm. It may be necessary, given the business need to work occasional overtime or weekends.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

• Perform encounter technical analysis on all incoming data from delegated provider groups.
• Provide technical encounter SME support to the organization (837, 277, TR3, Companion Guide, Administrative Guide).
• Apply analytical, technical skills/knowledge, and professional judgement to appropriately resolve any issues with encounter submissions for the NICE, COSMOS, OR FACETS platforms.
• Proactively identify weakness in the encounter submission path and remediate before major issues develop.
• Research and explain variances in data month over month for senior leadership meetings.
• Partner across the organization to root cause encounter issues and find solutions to both remediate occurrences in the present and in the future.
• Provide comprehensive reporting and analysis to senior leadership.
• Lead projects designed to improve the end-to-end UHC encounter process improvements.
• Monitor encounter reports to identify issue and provide follow through on resolution to any issues identified.
• Create easily digestible guides that document and define encounter submission best practices.
• Knowledge shares all technical skills with colleagues.
• Develop appropriate end to end controls and monitoring of key capitation and delegation operational processes, including member cost share and encounter data.
• Lead large, complex projects and provide appropriate subject matter expertise related to member responsibility and encounter data end to end processes.
• Root cause operational issues, document findings and implement action plans.
• Improve CapDel operational metrics to achieve Company standards.
• Work with UHN business partners to align the provider contracts and update the provider administration guide related to provider risk issues where appropriate to ensure clarity and the removal of contact interpretation as much as possible.
• Effective communication (written and verbal) of the issues, including any barriers or risks to their resolution.
• Continual business process transformation.

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 higher)
• 5+ years of experience using operational metrics, data/analytics, capacity planning, goals/objectives, and dashboards to run, interpret, and drive business performance
• 5+ years of experience developing and implementing business process change initiatives, including documentation
• 5+ years of experience in communication, internal and external executive level
• 5+ years of experience in leading/driving meetings and conversations
• 3+ years of experience with Microsoft office, including Access and Excel (VLOOKUP, pivoting, power query)
• 3+ years of experience with process improvement, workflow, benchmarking and / or evaluation of business processes
• Ability to work full-time from 8:00am to 5:00pm

Preferred Qualifications:

• Bachelor’s Degree (or higher)
• Experience in the Health Care industry
• CPA or MBA in Business Administration
• Knowledge of Value Based Contracting or Capitated Delegated Division of Responsibility business models
• 2+ years of SQL querying experience
• Black Belt or similar ability to design new processes
• Change Management experience

Telecommuting Requirements:

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

Soft Skills:

• High proficiency in analytical skills
• Intellectually curious
• Bias for action
• High proficiency in leading/driving meetings and conversations
• High proficiency with relationship skills
• High-level problem-solving skills
• Ability to create and drive new processes
• Time management and ability to keep projects moving forward

Careers with UnitedHealthcare. Work with a Fortune 5 organization that’s serving millions of people as we transform health care with bold ideas. Bring your energy for driving change for the better. Help us improve health access and outcomes for everyone, as we work to advance health equity, connecting people with the care they need to feel their best. As an industry leader, our commitment to improving lives is second to none.

California, Colorado, Connecticut, Nevada, Washington, or New York, Rhode Island Residents Only: The salary range for California / Colorado / Connecticut / Nevada / Washington / New York / Rhode Island residents is $67,800 - $133,100. 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.

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.

#RPO #YELLOW