Job Details
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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
The Provider Not Participating (PNP) Senior Business Analyst will complete telephonic outreach directly to Provider Offices to obtain their cooperation with Retrospective Chart Review Retrievals. The PNP Business Analyst will research Provider contact information as well as any provider-specific requests regarding membership research, chart reductions, payment or other requests to negotiate medical chart retrievals with provider offices. Candidates should be able to demonstrate flexibility and be adaptable to change and possess good independent decision-making capabilities.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
- Act as an escalation point for Medicare Advantage medical chart retrievals
- Perform provider contact information research
- Perform membership analysis to meet provider office requirements
- Obtain provider office commitment to provide medical records or allow our retrieval to obtain the medical records
- Collaborate with Care Delivery markets and business stakeholders to overturn Provider objections
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 Call Center or Outreach experience
- Healthcare industry experience
- Computer literacy in a Windows environment including MS Word, MS Excel, and Outlook
- Data analysis to obtain missing information and answer provider questions
Preferred Qualifications:
- 2+ years of Medicare Advantage experience
- 2+ years of Claims experience
- 2+ years of informatics experience
- Experience working with medical records
Soft Skills:
- Demonstrated excellent verbal and written communication skills
- Excellent customer service orientation
- Proven team player and team building skills
- Ability/flexibility to assume responsibilities and tasks in a constantly changing work environment
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for this role is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with al minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.
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.
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.
UnitedHealth Group is a health care and well-being company that’s dedicated to improving the health outcomes of millions worldwide. We are... Read more