Provider Data Specialist - National Remote

Requisition Number: 2341490
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
Provider Data Specialists (PDS) is primarily responsible for processing ACTs (add, changes, terms for new contracts, amendments, providers and/or facilities) received from the Contracting and/or Provider Advocates department/team. Position will primarily focus on Demographic ACT updates to meet CAA Regulation Requirement Sec. 116 c; ensuring updates are made within the two (2) business day turn-around-time. Serves as a liaison with Contracting and Provider Advocate Departments and upper leadership to ensure proper source documents are provided to support the processing of ACTs. Ensures data integrity in eVIPs for online provider directories, HCSA/Facets and OPC/AYS Portal. Position will be responsible for uploading completed and approved ACTs into Macess. Position may assist with overseeing the Network Operations Inbox for emails from the HCSA department pertaining to the submission/uploading of ACTs. Duties may also include running specific SQL reports to aid in the processing of ACTs, assisting internal/external departments with maneuvering various screens in Symplr database. Other duties as assigned.
Schedule: Monday-Friday 8-5 PST.
You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:

• Processing Demographic ACTs to meet CAA Regulation Requirements
• 15-20 ACTs daily minimum goal must be met
• 15 ACTs or less, monthly returns for corrections, must be met
• Run/utilize SQL reports to aid in the processing of specific ACTs
• Serves as a liaison between Network Operations, Contracting, Provider Advocates and HCSA Departments to ensure ACTs are processed correctly for data integrity
• Uploading ACTs to Macess - Daily

Minor Responsibilities:

• Assists with the Network Operations General Inbox for emails related to ACTs
  • PDS is to review email and conduct necessary research via eVIPs, Macess, Facets, PCP Master List and/or Healthsparq (HSQ) to determine if corrections are needed
  • After research, PDS is to respond and cc Network Operations department Manager and Supervisor and/or forward to Contracting/Advocates if deemed necessary

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions 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)
• 4+ years of data entry experience

Preferred Qualifications

• 4+ years of experience in the healthcare industry
• 6+ months of experience managing cross functional projects
• Intermediate level of proficiency with SQL
• Intermediate level of proficiency with MS Excel
• Beginner level of proficiency in tracking, trending, and reporting on metrics
• Proficiency in MS Access and PowerPoint
• Proficiency in Managed Care Organization terminology (e.g., MCO lines of business/products)

*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 hourly pay for this role will range from $17.98 to $32.12 per hour 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.
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