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.

This is an opportunity that's all about where you've been. Your experience. Your potential. Your skills. All solid up to now. It's also an opportunity to learn what's ahead. Because on the team at UnitedHealth Group, your potential and your impact can be career changing. We're driving ever higher levels of sophistication in how provider networks are formed and operated. The goal is to improve the quality of service while exploring new ways to manage costs. Here's where you come in. You'll use your solid customer service and consultative skills to meet with network providers and help enhance their experience and performance. As you do, you'll discover the resources, backing and opportunities that you'd expect from a Fortune 5 leader.

If you are located in WA, MO, or NC, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities

Facilitate end-to-end provider issues and resolution
Use pertinent data and facts to identify and solve a range of problems
Investigate non-standard requests and problems
Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers
Help implement training and development of external providers through education programs
Identify gaps in network composition and services to assist network contracting and development teams
Responsible for all related aspects of issue resolution
Claims systems utilization, claims-related business, and systems analysis
Ensure data integrity, data security and process optimization

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

3+ years of experience in a technical or metrics-based environment; preferably claims and/or customer service
2+ years of issue resolution experience
2+ years of experience in analyzing and solving customer problems in an office setting environment
1+ years of advanced level experience utilizing one or more of the following platforms COSMOS, CSP Facets, UNET, Cirrus, or NICE
1+ years of experience in communicating analysis, including trends and opportunities to clients and the business in writing and verbally
Intermediate level of proficiency with PC based software programs and automated database management systems (Excel, PowerPoint)
Will need to reside in WA, MO, or NC
Willing and able to travel up to 25% within state hired

Preferred Qualifications

1+ years of adjustment experience utilizing one or more of the following platforms COSMOS, CSP Facets, UNET, Cirrus, or NICE
1+ years of Investigation and Solutions Group resolution specialist experience
1+ years of escalated call experience
1+ years of experience solving complex problems and root cause remediation
1+ years of credentialing/contracting experience
Working knowledge of multiple platforms (COSMOS, CSP Facets, UNET, Cirrus, or NICE)
Proven ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product
All employees working remotely 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 $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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.

Qualifications

3+ years of experience in a technical or metrics-based environment; preferably claims and/or customer service
2+ years of issue resolution experience
2+ years of experience in analyzing and solving customer problems in an office setting environment
1+ years of advanced level experience utilizing one or more of the following platforms COSMOS, CSP Facets, UNET, Cirrus, or NICE
1+ years of experience in communicating analysis, including trends and opportunities to clients and the business in writing and verbally
Intermediate level of proficiency with PC based software programs and automated database management systems (Excel, PowerPoint)
Will need to reside in WA, MO, or NC
Willing and able to travel up to 25% within state hired
Candidates are required to pass a drug test before beginning employment

Benefits

If you are located in WA, MO, or NC, you will have the flexibility to work remotely* as you take on some tough challenges
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 $28.27 to $50.48 per hour based on full-time employment

Responsibilities

You'll use your solid customer service and consultative skills to meet with network providers and help enhance their experience and performance
Facilitate end-to-end provider issues and resolution
Use pertinent data and facts to identify and solve a range of problems
Investigate non-standard requests and problems
Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers
Help implement training and development of external providers through education programs
Identify gaps in network composition and services to assist network contracting and development teams
Responsible for all related aspects of issue resolution
Claims systems utilization, claims-related business, and systems analysis
Ensure data integrity, data security and process optimization
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

✨ Job alerts

✨ Job alerts

Financial Clearance Representative Associate - Remote Nationwide

Senior Provider Relations Representative - Remote within WA, MO, or NC