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Facets Senior Provider Pricing Configuration Analyst - Remote

Company: UnitedHealth Group
Location: San Jose
Posted on: November 20, 2023

Job Description:

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. -

The Facets Senior Provider Configuration Analyst will configure pricing into a Facets platform which uses NetworX pricing capabilities for Practitioners, Acute Care Hospitals, Critical Access Hospitals, Ambulatory Surgical Centers, Federally Qualified Heath Care (FQHCs), Rural Health Clinics, Dialysis, and Ancillary provider types. -The person in this role will be accountable for reading, interpreting, and translating provider fee for service and capitation contracts (or other pricing documents) into configuration design templates to facilitate contract loading (by self or others). -They will also participate in month-end and reconciliation processes required to support capitated provider contracts.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. -

Primary Responsibilities: -

  • Reading and interpreting provider contracts, or other pricing artifacts, to complete provider configuration design templates
  • Creating standard NetworX templates within Facets and on paper as a guide for Config Analysts to use to configure new -
  • Extracting and analyzing pricing data to help assess business processes such as configuration accuracy, capitation allocation payments, and to resolve provider pricing inquiries and/or pended claims
  • Complete quality control measures, to include claim modeling, to ensure accuracy of NetworX Agreement build -
  • Identify process improvement opportunities to improve accuracy and timeliness (i.e., automation, turn-around time, etc.)
  • Manage assigned inventory to ensure timely contract load -
  • Perform user acceptance testing on new/changed pricing tools
  • Serve as subject matter expert regarding configuration and/or Facets capabilities
  • Provide direction in selecting the appropriate Configuration Template(s) and/or request new designs for new pricing requirements

    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: -

    • High school diploma or GED equivalent -
    • 3+ years of Provider Pricing Configuration in Facets/NetworX
    • 3+ years of experience reading, interpreting, and translating provider contracts for professional, facility and ancillary providers
    • 3+ years of physician, facility, and ancillary contract reimbursement methodology with Medicare & commercial products
    • Provider Data Management experience
    • Experience building SQL queries, importing and exporting data using SSMS
    • Intermediate level of proficiency with Microsoft Word / Excel / Outlook / SharePoint
    • Demonstrated self-directed individual with a proven track record of solid organizational skills and ability to adapt quickly to change
    • Demonstrated solid customer focus with proven ability to anticipate, understand, and meet the needs of internal and external customers
    • Proven solid communication skills to translate complex or technical information clearly and concisely for diverse internal audiences
    • Proven ability to manage productivity and efficiency to visualize and achieve set goals for delivery of contracts for installation

      Preferred Qualifications: -

      • Undergraduate degree in business or healthcare
      • Experience configuring capitation contracts, capitated provider setup and capitation allocation payment analysis
      • Experience working with Cognizant DOFR / FARM applications
      • Medicare, Medicaid & Commercial pricing experience

        California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The hourly range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $32.60 to $63.99 per hour. 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). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.--- -

        *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy -

        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. - - - -

        - -

        Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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. - - -

        - - -

        OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. -

Keywords: UnitedHealth Group, San Jose , Facets Senior Provider Pricing Configuration Analyst - Remote, Professions , San Jose, California

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