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About UHG

Careers at UnitedHealth Group

 

We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM

 

Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com

 

Job Category:

Business Operations

Country:

US

Approximate Salary:

Not Specified

Position Type:

Full Time

Medical Management System Report Analyst - Ontario, CA

UHG - Ontario, California

Posted: 12/13/2018

Position will be responsible for Medical Management reporting and Health Plan reporting, which includes on schedule release of reports, report design, QA and modifications as identified. Setting up authorization rules, letters and system configuration.
 
Job Description
  • Responsible for routine scheduled Medical Management reports, including accuracy, modifications as needed and timely delivery. 
    • Operational reports
    • Health Plan reports
  • Responsible for development and delivery of special Health Plan report requests for auditing purposes that are in addition to the standard reporting requirements.
  • Responsible for designing and maintaining operational Medical Management and Health Plan reports.
  • Review ad hoc reporting requests in order to determine whether a standard reporting solution can be created.
  • Work with customers to troubleshoot and resolve any errors or discrepancies identified when reviewing distributed reports.
  • Supports the Medical Management Department through the management and interpretation of data, project management, process improvement activities and group facilitation.
  • Responsible for gathering, analyzing and reporting on data in support of business cases, proposed projects and utilization requirements.
  • Interprets key data and presents in a clear and concise manner.
  • Schedule and/or meet with internal and/or external customers in order to gather report requirements and data analysis needs.
  • Works with management in analysis requiring expertise in Utilization Management.
  • Responsible to work with I.T. to maintain current Medical Management reports on the reporting server.
  • Responsible for development, testing and implementation of Authorization Protocols.
  • Responsible for development, testing and implementation of Authorization and Case Management Letters.
  • Develop and maintain job aides for department training as related to the department responsibilities.
  • Work with MMSS Analyst Supervisor to perform needed system configuration additions/changes.
  • Work with MMSS Analyst Supervisor to perform QA system testing for system updates and/or enhancements.
  • Other duties as assigned.
  • Able to travel between locations.

Required Qualifications:
  • 2+ years of experience in the following areas are required:
    • Healthcare Industry
    • Business Analysis experience
    • Database management, data extracts, queries and / or report writing
  • Working knowledge of medical terminology, ICD 10, CPT, HCPC codes
  • Intermediate level of proficiency in Microsoft Excel
  • Proficiency in preparing reports via collection of data, report generation (graph)
  • Excellent practical knowledge in importing data for use in software, spreadsheets, graphs and flow charts
 
Preferred Qualifications:
  • Demonstrates knowledge of Oracle, SQL and HTML
  • Business Objects and Crystal Report Writing (including designing) a plus
  • Access Experience a plus
  • Strong Project Management skills
  • Familiarity with Capitated and FFS contract interpretations
  • Strong analytical, critical thinking and communication skills, both verbal and written
  • Some training experience
 
 
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
 
North American Medical Management, California, Inc (NAMM California) partnered with OptumHealth in 2012. NAMM California and OptumHealth share a common goal of bringing patients, physicians, hospitals and payers closer together in the mission to increase the quality, efficiency and affordability of care. NAMM California is a part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system. NAMM California develops and managers provider networks, offering a full range of services to assist physicians and other providers in supporting patient care coordination and their managed care business operations. For over 18 years, NAMM California has been an innovator in health care with a track record for quality, financial stability, extraordinary services and integrated medical management programs. NAMM California is well positioned to continually invest in its infrastructure and systems for the benefit of its provider clients and to accommodate the impending changes that will come forth from healthcare reform.
 
The NAMM California provider clients represent a network of almost 600 primary care physicians and over 3,000 specialists and work with the premier hospitals in their respective markets.
 

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.
 
 
Job Keywords: Business Analyst, Reporting Analyst, Data Analyst, SQL, Excel, Oracle, HTML, Business Objects, Crystal Reports, Capitation, FFS contracts, healthcare, ICD-10, C{T, HCPC

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