Job: Provider Data Consultant, Provider Pick

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Jobing Description

UnitedHealthcare, a UnitedHealth Group company, provides network-based health and well-being benefits and services for employers and consumers nationwide. We use our strength, diversity and innovation to improve the lives of the more than 16 million people who receive our unique blend of packages and programs. And our endless pursuit for excellence in everything we do extends to your career as well. Join us today for an inspired and purposeful mix of professional growth opportunities and personal rewards.


We're seeking a flexible self-starter with an investigative nature to fill a Provider Data Consultant position on our Network Expertise and Policy team in the area of system configuration of provider networks and process change initiatives. In this role you would enjoy tremendous opportunity for growth, as well as the chance to become a recognized subject-matter-expert on provider network data. You will also gain exposure to all areas of the company as you focus on the following responsibilities:


Providing subject matter expertise and operational support of provider selection issues, NPI and system enhancement requests

Performing business analysis for new provider selection related initiatives

Capture and report provider selection and NPI statistics

Provide business support of Enterprise wide provider selection initiatives including, but not limited to, participation in requirements gathering calls, data analysis, documentation of test scenarios and post deployment support.

Work closely with IT to review issues, enhancements and data reports related to provider selection.

Developing and documenting new processes

Writing of provider data policies and procedures and training topics

Designing job aides and monitoring these documents through the development and approval process

Speaking on national calls to present new documents or updates to internal departments

Making presentations

Working with operational areas to provide assistance with the implementation of new initiatives

Performing business analysis for new provider selection related initiatives

Speaking on national calls to present new documents or updates to internal departments

Making presentations

Working with operational areas to provide assistance with the implementation of new initiatives

Skills / Requirements

3 - 5 years experience with healthcare provider data and its business usage including contracting is required

NDB experience required

Facets, COSMOS, NICE, Pulse provider data experience a plus

3 - 5 years of claims experience on UNET, COSMOS, NICE, Pulse or Facets preferred

Conceptual thinking capability

2 to 3 years prior professional writing experience is required, including writing of Policies and Procedures

At least 1 year of prior experience with a Policy and Procedure governance and sign off process

2 to 3 years experience in presenting information at national forums or in large project group meetings

Willingness to handle a variety of different types of project assignments vs. a fixed role/function

2 to 3 years experience in successfully managing one or more major projects, which integrates multiple business areas or systems.

Strong business partner focus.

Ability to prioritize in an environment of rapid change

Solid organizational and interpersonal skills

Self-starter; team player; quality minded; focused; committed; work independently

Able to stay committed to long-term project goals

Able to direct project outcome based on long term business objectives.

Candidates must have Microsoft Office skills. Prior experience with Visio and Microsoft Project preferred

Bachelor's degree preferred.



UnitedHealth Group offers a full range of comprehensive benefits, including medical, dental and vision, as well as a matching 401k and an employee stock purchase plan.



Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V.