At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life's best work.(sm)

The Provider Data Analyst / Quality Auditor position is accountable for various activities related to the provider data audits. Primary duties are performing audits to assess the accuracy of provider demographic data, contractual data, and directory against provider attestations.  Job duties will include locating and reviewing attestations in various formats, online provider directories, NDB and various systems, PhyCon, Emptoris and provider data resources in Knowledge Central.  Additional duties may also include participation in special projects for provider or QuEST initiatives and other tasks as necessary.

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

Primary Responsibilities:

• Review, research, and audit attestation data submitted by providers (Demographic and Contractual for all applicable platforms and all regions/markets)
• Ensure provider data displays correctly in online directories
• Clearly document any discrepancies identified in audit tool
• Validate audit responses and ensure defects are remediated
• Investigate non-standard requests and problems
• Prioritize and organize own work to meet deadlines
• Provide explanations and information to others on topics within area of expertise
• Identify potential data or process gaps
• Monitor own work to ensure accuracy and completeness of audits
• Work independently in a production related role (both production and quality metrics)
• Excellent oral and written communication skills
• Ability to adapt to change

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:

• 2+ years of experience within an auditing and/or researching capacity in the healthcare industry
• 2+ years of provider contractual experience in the healthcare industry
• Intermediate knowledge of provider contractual and demographic processes, with the ability to view and understand provider contracts in all regions and markets
• Intermediate level of proficiency with Emptoris, CLM
• Intermediate level of proficiency with NDB, NICE, CSP Facets, COSMOS, PULSE, IMPACT and PhyCon
• Intermediate proficiency in MS Excel
• Intermediate level of proficiency in MS SharePoint

Preferred Qualifications:

• High School Diploma / GED or higher
• System experience with Core platforms (NDB, NICE, CSP Facets, COSMOS, PULSE, IMPACT and PhyCon)
• Experience locating and understanding provider contracts
• Experience tracking production using Omega
• Proven excellent written and oral communication and organizational skills  

Soft Skills:

• Organization
• Customer Focus
• Collaboration
• Problem Solving, Researching, Analysis
• Flexibility
• Able to adapt to change
• Team Player

Careers with UnitedHealthcare. Work with a Fortune 5 organization that’s serving millions of people as we transform health care with bold ideas. Bring your energy for driving change for the better. Help us improve health access and outcomes for everyone, as we work to advance health equity, connecting people with the care they need to feel their best. As an industry leader, our commitment to improving lives is second to none.

California, Colorado, Connecticut, Nevada, New York City, or Washington Residents Only: The hourly range for California, Colorado, Connecticut, Nevada, New York City, or Washington residents is $27.07 to $53.08. 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: 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.