Senior Healthcare Provider Network Program Specialist - Reporting Analyst / Regulatory and Compliance

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 Senior Network Program Specialist is responsible for the successful program design, compliance with network requirements, network assessment and selection, and program/product implementation. This includes enterprise-wide Clinically Integrated Network teams that focus on specific clinical area Lines of Service (e.g., Cardiology, Women's Health, Oncology, etc.) to improve the quality and affordability through improvements in appropriateness and effectiveness. Senior Network Program Specialists may perform network analysis and strategy development and implementation; obtain data, verify validity of data, and analyze data as required, and analyze network availability and access. Other responsibilities may also include making recommendations regarding use, expansion, selection of networks for various products based on that analysis. Primary Responsibilities:

Assess and interpret customer needs and requirements
Identify solutions to non-standard requests and problems
Solve moderately complex problems and/or conduct moderately complex analyses
Work with minimal guidance; seek guidance on only the most complex tasks
Translate concepts into practice
Provide explanations and information to others on difficult issues
Coach, provide feedback, and guide others
Act as a resource for others with less experience
Excellent ability to work with large amounts of data, understanding network and regulatory environments

Required Qualifications:

Undergraduate degree or equivalent experience
3+ years of experience with network data management in a managed care environment
3+ years of experience in provider data analysis
3+ years of experience with claims processing or resolution

Familiarity with regulatory/compliance language or past experience working on projects/tasks that dealt with regulatory/compliance issues

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

Ability to prioritize multiple tasks in an environment of rapid change

Excellent phone presence and communication skills

Intermediate proficiency in MS Office (Excel and PowerPoint)
Preferred Qualifications:


3+ years of experience with claims processing systems and provider data bases, claims system testing experience
2+ experience working with reporting tools and generating effective reports
Project management of experience
MS Access
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 14 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can 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: Healthcare, Managed Care, Hospital Contracting, Physician Contracting, Ancillary Contracting, Provider Network, Network Development, Provider Services, Provider Education, Provider Relations, Compliance, Regulatory, telecommute, telecommuting, telecommuter, work from home, remote, travel