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Senior Network Program Specialist - Remote

Optum
United States, Minnesota, Eden Prairie
11000 Optum Circle (Show on map)
Nov 19, 2024

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

If you are located in Eden Prairie, MN, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:



  • Able to build MS Access databases, create forms, queries, and tables to manipulate and track data
  • Assess and interpret customer needs and requirements
  • Perform claims analysis
  • Obtain, validate, and analyze data as you analyze network availability and access
  • Identify solutions to non-standard requests and problems
  • Solve moderately complex problems and/or conduct moderately complex analyses
  • Provide recommendations and guidance built off the analysis you have performed
  • Provide explanations and information to others on difficult issues
  • Work is self-directed and not prescribed
  • Works with less structured, more complex issues
  • Utilize your critical thinking skills to identify trends and potential issues
  • Coach, provide feedback, and guide others
  • Function as a resource for others with less experience



Our Transplant Solutions product suite encompasses access to high quality centers as well as utilization and case management of these complex conditions:



  • Transplant Resource Services, offering access to COE and extended networks for solid organ and stem cell transplantation and ventricular assist devices (VADs)
  • Managed Transplant Program, a transplant risk carve-out that provides health plans with both focused transplant clinical management and price predictability for transplant costs
  • Congenital Heart Disease Resource Services, offering access to Centers of Excellence for this rare yet complex condition
  • Bariatric Resource Resources, a comprehensive solution to prepare members for bariatric surgery and access Centers of Excellence
  • Gene therapy and Chimeric antigen receptor T-cell therapy (CAR-T therapy) provider contracting services, an expansion of our stem cell transplant network contracting capabilities that offers financial relief and patient access for this novel, emerging cellular therapy


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:



  • 2+ years of experience with network data management in a managed care environment
  • 2+ years of experience in provider data analysis
  • 2+ years of experience working with reporting tools and generating effective reports
  • Intermediate proficiency in MS Access and Excel
  • Proven ability to convey complex information to others and make it more easily understood
  • Proven ability to prioritize multiple tasks in an environment of rapid change


Preferred Qualifications:



  • 2+ years of experience with provider databases
  • Project management experience
  • Experience with claims processing systems and provider databases
  • SharePoint knowledge
  • Intermediate proficiency in MS PowerPoint
  • Excellent phone presence and communication skills


*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

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