Remote — Payment & Network Strategy Lead

UnitedHealthcare; Plymouth (MN); Remote; USD 73,000 - 130,000; Full time

Job summary

UnitedHealthcare is looking for a Payment Appendix Manager to join our remote team in the United States. You will support enterprise-wide Clinically Integrated Network initiatives, manipulate data, coordinate with provider groups, and manage cross-functional projects with sales, consulting or clinical teams to improve quality and affordability.

You will analyze data, design and implement network programs, and drive strategies that enhance network availability and access.

Qualifications

• 5+ years of experience in claims processing, provider data maintenance, contracting or contract loading.
• 5+ years of experience with claims systems.
• 3+ years of experience with contract submission, validation and maintenance.
• Demonstrated solid knowledge of business processes that impact facility/ancillary contact loading and auditing.
• Proficiency with all facility/ancillary contract reimbursement methodologies.

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.
• Serve as a key resource on complex and/or critical issues.

Skills

Claims processing

Provider data maintenance

Contract loading

Claims systems

Contract submission/validation

Job description

UnitedHealthcare is looking for a Payment Appendix Manager to join our remote team in the United States. You will support enterprise-wide Clinically Integrated Network initiatives, manipulate data, coordinate with provider groups, and manage cross-functional projects with sales, consulting or clinical teams to improve quality and affordability.

You will analyze data, design and implement network programs, and drive strategies that enhance network availability and access.