Manager, Provider Data, Polaris - NDB Required - Possible Telecommute at Basking Ridge

Job Description

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your lifes best work.Were seeking a flexible self-starter with an investigative nature to fill a Provider Data Management business role on our Network Expertise and Policy team to focus on thePolaris program. In this role you would enjoy tremendous opportunity for growth, as well as the chance to be a recognized subject-matter-expert on healthcare provider data. You would also gain exposure to all areas of the company as you focus on the following responsibilities: -Provide subject matter expertise on provider demographics, credentialing, and contracted rates including but not limited to products, networks, IPA, contract selection, capitation, tiered networks, fee schedules, facility rate tables, Tax IDs, address data, complex provider organizations. -Take an active role in Agile IT development processes including participation as part of a Scrum team and participation in Sprint sessions. -Participate and provide business direction on the Enterprise Data Model for provider data. -Assist in project managing provider follow-up tasks arising from the Agile (Sprint) sessions, capturing key tasks, owners and driving resolution and closure of the issues.-Provide reference data for vendor system setup for systems involved in the UBCS prototype intiative.-Utilize vendor systems to configure network business rules and load provider demographic data and contracted rates.-Lead cross functional or one on one discussions to capture and document business rules and detailed scenarios pertaining to complex fee schedule or facility pricing methods, premium designation, areas of expertise, provider types, credentialing and provider demographics, interfacing with internal business partners to secure information and examples-Translate provider data setup and configuration rules for networks currently found on UNET, Facets, NICE, Pulse or COSMOS.-Provide business, operational and workflow expertise surrounding upstream and downstream uses of provider data including use of the data for Claim, Clinical purposes, Customer Care, Directories, provider and member portals, ad hoc reporting.-Contribute to operational impact and staffing analysis comparisons for the vendor sytems that are in scope for the Polaris prototype.-Present updates on our progress in the provider domain for Polaris to stakeholders.UnitedHealth Group offers a full range of comprehensive benefits, including medical, dental and vision, as well as a matching 401k and an employee stock purchase plan.Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V.

Job Requirements

Requirements:4+ years of experience with healthcare provider data and its business use.-NDB experience.2+ years experience in successfully managing one or more major projects, which integrates multiple business areas or systems. -2 yearswriting experience.-2+ years of claims experience preferably on UNET.-2+ years experience in presenting information in large project group meetings. -Candidates must have Microsoft Office skills.Desired Experience and Competencies: Strong business partner focus. Facets, COSMOS, NICE, Pulse, UNET experience. Experience on an Agile development project. 1 year RSA IT lifecycle experience.Able to effectively interact with multiple teams in a fast paced environment where 24-48 hour TAT on open issues is expected.Demonstrated ability to drive open issues to rapid resolution and use of project management tools.Supervisory or managerial experience.-Self-starter; team player; quality minded; focused;work independently.-Solid organizational and interpersonal skills.-Willingness to handle a variety of different types of project assignments when necessary vs. a fixed role/function.-Detail oriented and strong analytic skills.-Conceptual thinking capability.Able to direct project outcome based on long term business objectives.Able to stay committed to long-term project goals.-Able to prioritize in an environment of rapid change.- Experience writing policies and procedures. -Bachelors or higher level degree. UnitedHealthcare, part of the UnitedHealth Group family of companies, is comprised of three specialized businesses dedicated to meeting the health care benefits needs of individuals and groups; all part of something greater, but each with a specialized focus:UnitedHealthcare Employer & Individual works with individuals, small businesses and large multi-site employers to provide innovative, affordable benefits services.UnitedHealthcare Medicare & Retirement is focused on serving Americans over the age of 50. It is the largest business dedicated to meeting the growing health and well-being needs of aging individuals in the nation, serving one in five Medicare beneficiaries through a comprehensive and diversified array of products and services through four industry-leading businesses.UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.Together, we are removing the barriers that keep people from receiving the kind of quality health care that makes a difference. We focus on Integrity, Compassion, Relationships, Innovation and Performance as we empower people to achieve better health and well-being.Come grow and thrive in our culture of innovation and ideas. Because there is no opportunity greater than the quest to help people live healthier lives.
Country: USA, State: New Jersey, City: Basking Ridge, Company: UnitedHealth Group.