Sr. Provider Data Specialist - Wausau, WI; San Antonio, TX; Cincinatti, OH

UHG Cincinnati, OH

About the Job

You know it. We know it. Change is sweeping through health care in ways that that go beyond the basics covered in the news. Organizations like UnitedHealth Group are driving ever higher levels of sophistication in how provider networks get shaped, perform and are compensated. Everything is open to new ideas and innovation. And a lot of the good stuff starts in roles like this. Join us and you'll play a key role in managing data about the Physicians and Specialists who are part of our Provider networks. This role will put you on a team of incredibly talented technology and business professionals. You'll discover the resources, backing and opportunities that you'd expect from a Fortune 6 leader.

The following duties cover what are generally believed to be principal and essential functions of the job. Specific circumstances may allow or require some people assigned to the job to perform a somewhat different combination of duties.

Note: Addendums may be added to state duties, responsibilities and / or requirements unique or specific to assigned area.

Primary Responsibilities:
  • Apply knowledge / skills to a range of moderately complex activities
  • Review customers and/or prospective customers’ geographic locations to recommend optimal network solutions.
  • Review RFP requirements and complete necessary reports and documentation to support recommended network solutions.
  • Demonstrate great depth of knowledge / skills in own function
  • Provide feedback to internal functions about any rules, guidelines and strengths or weaknesses with our networks that may impact desired network solutions.
  • Review and communicate as needed demographic and discount information needed to determine network recommendations within the team and with the sales team.
  • Provide guidance to internal functions regarding reporting capabilities surrounding network requests.
  • Sometimes act as a technical resource to others within our function.
  • Provide analytical support to the Network Specialists in reviewing and explaining renewal recommendations.
  • Provide analytical support to the Network Administrators in preparing for customer presentations, new network reviews, and network recommendations surrounding non - standard RFP reviews.
  • Explain and answer questions related to our standard network reports supporting our recommended network solutions.
  • Works with team to solve complex problems.
  • Coordinates with management and other team members to develop answers to non - standard RFP questions.
  • Supports business unit in updating and analyzing network demographic and claim information as needed.
  • Plan, prioritize, organize and complete work to meet established objectives.
  • Coordinate with sales functions to ensure network requests are completed within our standard timelines.
  • Other duties as assigned.

Required Qualifications

  • High school diploma / GED or higher
  • 4+ years experience in the health care industry
  • Intermediate level of proficiency with MS Excel with the ability to create and edit spreadsheets
  • Proficiency in MS Access with the ability to create and edit spreadsheets

Preferred Qualifications

  • Undergraduate degree or higher

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.


Keywords: senior, provider, data, specialist