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Senior Network Program Specialist - Minnetonka, MN

UnitedHealth Group


Location:
Minnetonka, MN
Date:
12/08/2017
2017-12-082018-01-06
Job Code:
740571
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Job Details

740571 Senior Network Program Specialist Minnetonka MN

Senior Network Program Specialist - Minnetonka, MN (740571)

Position Description

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)

 

The position will be responsible for providing day-to-day operational support of all Medicare/Medicaid and Delegated business. The Sr. Network Program Specialist will drive the completion of research and resolution of escalations, new business support, provider data accuracy, and successful provider loads to claims platforms.  This position will be utilizing various tools and business partners to help delivery quality, efficient, and creative solutions for Medicaid, Medicare, and Delegated Operations. The Sr. Network Program Specialist will ensure all systems and processes are up and running successfully; in addition to managing risks, issues, and documenting decisions.

 
Primary Responsibilities:
  • Serve as the subject matter expert for Medicare / Medicaid and Delegated operational processes

  • Gather and analyze case data, and resolve issues

  • Manage and mitigate risks associated to the loading of provider data to all claims platforms

  • Research and resolve complex inquiries / issues requiring expert job knowledge and comprehensive understanding of downstream impacts

  • Clearly and consistently track metrics and goals

  • Lead and participate in regular implementation meetings and provide status to leadership

  • Develop and improve existing processes and tools

  • Share best practices with other workgroup members

  • Serve as a resource / role model to other team members

  • Mentor new hires and provide functional and technical expertise

  • Provide ad hoc support to internal customers and team



Required Qualifications:

  • Bachelor’s degree or equivalent work experience

  • 1+ years of experience in provider data analysis

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

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

  • Intermediate proficiency in MS Office (Excel and PowerPoint)

  • Excellent phone and written presence and communication skills

  • Must live within commutable distance of the location listed for this specific career opportunity

Preferred Qualifications:
  • Salesforce
  • MS Access
  • Experience within medical, vision or dental

  • Experience with claims processing systems and provider data bases, claims system testing experience

  • Ability to quickly build strong meaningful relationships both internally and externally

  • Experience in the healthcare industry

  • Experience leading large matrix organizational projects / initiatives

  • Ability to communicate complex information tailored specifically to the audience so that it is easily understood

  • Ability to stay calm in difficult and highly stressful situations

  • Project management experience
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
 
 

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 data management, provider data analysis, claims processing or resolution, Minnetonka, MN, Minnesota

 

Job Details

  • Contest Number740571
  • Job TitleSenior Network Program Specialist - Minnetonka, MN
  • Job FamilyNetwork Management
  • Business SegmentEmployer and Individual

Job Location Information

  • Minnetonka, MN
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelIndividual Contributor
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionNo
  • Overtime StatusExempt

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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