UnitedHealthcare: Building the Health Care System of Tomorrow
At UnitedHealthcare, we’re dedicated to simplifying the health care experience, creating healthier communities, and removing barriers to quality care. Join us in building 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 Reimbursement Config SME Position Overview
The Provider Reimbursement Config SME is responsible for reviewing, interpreting contract language, state requirements, and reimbursement policies. As a key member of the PDO Migration & Strategy team, you will use your Facets (Core or NetworX) knowledge to work on multiple migration and implementation projects simultaneously. Enjoy the flexibility to work remotely from anywhere within the U.S.
Primary Responsibilities:
- Claims processing systems using Facets
- Pricing Configuration using Facets (NetworX)
- Review, interpret, and verify contract language, information, and intent to load information into systems properly
- Ensure contract templates can be administered across operations (pricing config, claims, etc.)
- Communicate identified discrepancies to Network Management, Contracting, and Pricing Requirement teams
Required Qualifications:
- 4+ years of experience with Facility/Ancillary and Professional Provider reimbursement methodologies without loading guidelines into various platforms
- Subject Matter Expert (SME) in Facility/Ancillary and Professional Provider Configuration Reimbursement as no training is offered
Preferred Qualifications:
- Proven ability to manage multiple projects concurrently while maintaining a high level of quality and commitment to project timeframes
- Proven to be self-directed and experience multi-tasking effectively between two or more activities or sources of information
California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for residents in these states is $67,800 to $133,100 per year. Pay is based on several factors, including but not limited to education, work experience, certifications, etc. 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).
Telecommuter Policy: All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
UnitedHealth Group’s Mission: Our mission is to help people live healthier lives and make the health system work better for everyone. 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 and Equal Opportunity: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer. 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.
Drug-Free Workplace: UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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