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Business Analysis Consultant (Medicaid Encounters) - Minnetonka, MN

UnitedHealth Group

Minnetonka, MN
Job Code:
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Job Details

Business Analysis Consultant (Medicaid Encounters) - Minnetonka, MN(Job Number:711277)

Community & State participates in programs in 26 states and serves approximately four million beneficiaries of acute and long-term care Medicaid plans, the Children’s Health Insurance Program (CHIP), Special Needs Plans and other federal and state health care programs. Our mission is to help the people we serve live healthier lives, and our goal is to be the plan of choice .Join us! Your passion for performance can fuel your life's best work.(sm)


The Community & State Encounter Program Management team has oversight of complete, timely and accurate encounter submissions to state customers. This includes working with health plans and states on process improvements, implementing new requirements and analyzing current production results.


Primary Responsibilities:

  • Ensure we meet or exceed Medicaid Encounter requirements and internal goals by:

    • Being a Medicaid Encounter Subject Matter Expert (SME) for multiple states
    • Acting as team lead for certain encounter functions for multiple states
    • Ensuring Encounter submissions meet state requirements
    • Monitoring Encounter submission and acceptance rates
    • Reviewing, researching, investigating and correcting encounter issues through data and process analysis
    • Where process or system changes are necessary, develop short and/or long-term resolutions by identifying root causes using data files, provider files, diagnosis files, etc.
    • Develop collaborative relationships with internal partners in order to ensure Encounter goals are met; includes partnering with functional teams (e.g., Provider Data, Claims, etc.) accountable for issues impacting Encounters
    • Maintaining Encounter reporting describing results against internal goals; presenting results and issue updates to health plan leadership or functional partners (e.g., other operational functions or IT)
    • Developing relationships with state partners in order to resolve issues
    • Develop innovative approaches to increase efficiency in meeting state requirements and internal goals

Job Business Analysis
Primary Location US-MN-Minnetonka
Other Location 
Organization C&S Ops - Encount & Bus Intel
Schedule Full-time
Number of Openings 1
Apply on the Company Site

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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