Provider Engagement Team Issue Management Analyst – Remote Nationwide

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Provider Engagement Team Issue Management Analyst is a senior-level role that will proactively and reactively engage with provider networks based upon detailed risk analysis to review claim trends, educate on coding, and manage escalations end to end while ensuring delivery on financial commitments. This role requires strong communication skills (written and oral), strong emotional intelligence, significant client-facing experience in navigating challenging conversations and subject matter expertise in coding and payment integrity solutions. The successful candidate will play a pivotal role in driving strategic, impactful solutions and enhancing provider engagement to deliver on growth opportunities for all UHC Lines of Business.

The successful candidate will be a seasoned professional with proven experience working across multiple levels in the organization including senior management. Your passion to find repeatable methods to drive consistent delivery of solutions and develop trusted partnerships are key elements in the foundation of this role. 

Some of the day-to-day activities may include but are not limited to, oversight on current in-year initiatives and delivery on client commitments, mitigating risks and issues to ensure successful delivery of plans, developing and taking action to deliver new strategies for growth, and conducting detailed end to end data analysis to educate providers/health systems on billing trends across Payment Integrity. 

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges

Primary Responsibilities:

Growth

• Establishes and maintains deep customer relationships across all Optum Payment Integrity products
• Understands client’s gaps, potential solutions, and implementation barriers for new opportunities
• Identifies new opportunities to drive organic growth; leverages capabilities and services from across the enterprise to create market-leading client solutions

Operating Discipline

• Anticipates policy and regulatory issues; supports the OPI Operations team in driving improvements and creating action plans to mitigate the risk
• Provides guidance, expertise, and/or assistance to business partners with completion of tasks and complex issue resolution related to provider and facility issues
• Reviews data and operational performance reports to identify root cause issues; develop and implement process improvements and effective corrective action plans.
• Creates and leads program reviews with relevant stakeholders to share value story and collaboratively identify opportunities for continuous improvement

Client Management

• Drives the organization to deliver industry-leading client service and satisfaction; champions the importance of maximizing the client experience
• Develops and communicates highly complex concepts in both written and verbal formats to a wide variety of audiences including within Joint Operating Committee meetings.
• Education of Payment Integrity services & training to teams, executives, clients and providers.
• Works with internal and/or external partners (e.g., UHC PI, UHN, PI Operations, Business Intelligence, Provider Operations, Claims Operations) to identify root cause trends for provider & facility issues, corrective action plans to drive resolution and building out appropriate reporting (dashboards, scorecards, reports, etc.) for program performance review
• Establishes and monitors performance against service level agreements to measure program performance (e.g., turnaround time, quality, effectiveness, etc.)
• Develop and lead client rhythm of business with appropriate stakeholders
• Coordinates with appropriate partners to interpret contractual requirements and ensure effective execution and compliance with contractual and regulatory stipulations
• Develops corrective action plans to address and resolve relevant stakeholders’ operational concerns or issues
• Utilizes stakeholder input to help shape and implement continuous improvement in operational quality and financial performance

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:

• High School Diploma/GED (or higher) 
• 8+ years of experience working with senior-level c-suite executives and demonstrating progressively increasing responsibility for client relationship management and consultation
• 5+ years of experience working in a matrixed and high change environment handling tight deadlines
• 5+ years of relationship management experience resolving complex issues with accountability for results
• 5+ years of experience leading management initiatives
• 5+ years of experience utilizing operational metrics, data/analytics, goals/objectives and dashboards to run, interpret, and drive business performance
• 5+ years of experience managing sensitive, escalated situations with internal and external customers
• 5+ years of experience leading various Operational teams and functions
• 5+ years of experience managing budgets and/or business cases associated with projects and savings achievement
• Advanced level of proficiency with Microsoft Office suite of products
• Ability to occasionally travel domestically
  

Preferred Qualifications:

• Advanced degree (e.g. MBA, MHA)
• Experience in health service, disease or claims management across the insurance industry 
• Industry knowledge desired, but not required including:
  • Understanding of healthcare compliance/regulatory environment
  • Detailed knowledge of impacts to claims savings.
  • Experience in progressive health service, disease management or claims management across the insurance industry

Soft Skills:

• Self-motivated and able to work with little direct supervision and drive results with disciplined follow though
• Must demonstrate an ability to message, position, and present information for maximum customer impact and influence
• Highly collaborative style; experience developing, implementing, and delivering on growth strategies
• Ability to establish credibility and build relationships at all levels

Key Competencies:

• Articulate. Acts in a professional manner; articulates messages clearly and succinctly; ability to deliver tough messages; adjust content and style to different audiences; creates professional work products
• Assertive. Confident in the solution and messaging; judiciously and proactively interjects with facts and opinions
• Critical Thinker. A true problem solver; skill in playing out alternative scenarios; deals well with ambiguity and complexity; demonstrates raw intelligence
• Empathetic. Develops bonds and connections with the client, business partners, and other key stakeholders; focused on relationships and mutual understanding; treats vendors, customers, peers, subordinates, and supervisors with the same level of respect
• Enthusiastic. Has a bias toward action and a passion for the work; willing to be outwardly positive; not a defeatist, shows tenacity in the face of setbacks; proactively seeks to understand issues and pursue solutions
• Perceptive. Able to understand implied business problems; ability to see other viewpoints and apply proper communication techniques in response to changing environments; has insight into what motivates people and listens to alternative ideas before making decisions
• Team Developer. Can bring people together for a common cause; develops vision of success and drives to it
• Time Management. Establishes realistic goals and does not create a false sense of urgency; Understands how to prioritize competing needs/tasks without being overwhelmed
• Trustworthy. Can be counted upon; follows through on tasks and requires little/no supervision
  

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

    

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable. 

    

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. 

    

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 

     

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.

   

     

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

    

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.

    

   

#RPO #GREEN