Healthcare Benefit Management Program Consultant - Cincinnati, Ohio - San Antonio, TX or Wausau, WI

UHG Wausau, WI

About the Job

There comes a point when you’re ready to take off the training wheels and start guiding others. If that’s where you are today, let’s talk about where you can be tomorrow with our leading, global health care organization. UnitedHealth Group is driving ever higher levels of sophistication in how provider networks are composed and compensated. Everything is open to new ideas and innovation. Here’s where you come in. Your expertise in provider networks can help us build in the next phase of evolution. In this role, you’ll use your knowledge and analytical skills to help determine how clinical providers group up by specialty and service line. As you do, you’ll discover the resources, backing and opportunities that you’d expect from a Fortune 6 leader.  
Primary Responsibilities:
  • Work with internal/external customers on reviewing network performance and developing recommendations going forward
  • Perform analysis and strategy development and implementation  for our network and pharmacy benefit management products
  • Drive program design and implementation to improve quality and affordability through improvements in product offerings around our network and pharmacy benefit management products
  • Obtain, validate and analyze data as you analyze network availability and access
  • Serve as a key resource on complex and/or critical issues
  • Serve as key resources for corporate projects impacting network and pharmacy benefit management offerings
This is an opportunity to truly challenge yourself. You’ll work on many different aspects of Provider Networks and Pharmacy Benefit Managers in this role including manipulating data, working with Sales and Account Management, managing projects, educating customers and navigating any issues with other teams such as sales, consulting or clinical. 

Required Qualifications:
  • Undergraduate degree or equivalent work experience
  • 5+ years of experience with healthcare data analytics and reporting
  • Experience with all facility/ancillary contract reimbursement methodologies
  • 2+ years of experience working with external customers on data analytics and presenting results/recommendations
Preferred Qualifications:
  • Project management experience
Building diverse, high quality provider networks is creating greater access to health care and improving the lives of millions.  Join us.  Learn more about how you can start doing your life’s best work.(sm)
Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)

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:  Managed Care, health care, Network Program Specialist, network requirements, network assessment, network selection, network data management, provider data analysis, medical claims, claims processing, claims resolution, medical coding, project management