You dream of a great career with a great company – where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.
This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 6 leader.
Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.
Provider Data Management (PDM) Specialists are responsible for ensuring the integrity and accuracy of provider data in all applications. PDM Specialists are expected to work collaboratively with all internal and external stakeholders in an effort to meet and / or exceed all regulatory and industry provider data quality and accuracy standards. PDM Specialists are responsible for the installation of assigned accounts, including, but not limited to: structure building and billing set up, structure revisions, researching & resolving structure issues, database loading, and preparation of plan materials such as administrative documents and customer education materials.
- Coordinate add, changes and terminations of contracted providers on behalf of CDO
- Monitor and coordinate additions, changes and terminations for affiliated contracts from the Health Plan
- Manage and resolve complex provider data issues, such as mass change updates, limited reconciliations and direct submissions of urgent requests
- Create and maintain multiple databases along with the ability to provide appropriate reports and statistical data to other department designees for review, follow-up and resolution
- Participate in the reconciliation and provider data projects
- Act as the primary point of contact for provider research related to contract configuration
- Receive, triage and process secure provider portal requests
- Coordinate credentialing provider data from CDO to credentialing team
- High School Diploma / GED (or higher)
- 2+ years of work experience in a corporate setting
- 2+ years of credentialing or provider data experience
- 2+ years of provider data management experience
- FACETS and / or Xcelys experience
- Consulting experience
- Experience working with Microsoft Excel including formulas, calculations, charts, and graphs
- Experience working with Microsoft Excel including creating new / editing existing spreadsheets, adding / deleting rows, adding / deleting cells, merging rosters, pivot tables, and sorting / filtering
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.
Keywords: provider, systems, update, management, credentialing, FACETS, Xcelys, provider data