We'll put you in the driver's seat on vital projects that have strategic importance to our mission of helping people lead healthier lives. Yes, we share a mission that inspires. We need your organizational talents and business discipline to help fuel ours. It's the opportunity to do your life's best work.(sm) Use your Sharp Analytical Skills to help us support, compile and report key information! Create, enhance, and maintain budget or financial planning models, surveys, benchmarks. Evaluate, interpret and analyze data and business process and analyze / monitor new, routine and ad hoc reports. Provide support when compiling and reporting information and assume responsibility for data integrity among various internal groups and/or between internal and external sources. Support short term operational activities. Primary Responsibilities:This position is the managing and coordination of contracted and employed PCPs for Texas and Florida to include their status, demographic information and their membership on a daily basis. They will work closing with the 7 health plans by submitting weekly rosters of new PCPs, changes, terminations and ensure all updates including panel moves are completed by health plans timely and accurately to ensure all is 100% accurateIn addition, reconciliation is to be done weekly by reviewing, analyzing PCP information is loaded accurately to ensure all is 100% accurate and timely for each of the 7 health plans in their applications including the online provider portal. (Submit and work with the health plans on a weekly basis in regards to any PCP initiated member moves to increase PCP quality metrics)Review internal rosters to ensure all PCPs have correct health plan assignment and health plan idsRuns cap and should make sure the cap is correctReviews the data exchange emails. Answer all questions related to PCP set up and panel assignment on a daily basis with appropriate departments or health plansReview yearly AEP directory for each of the 7 health plans to ensure all information is loaded accurately in their applications and including the online portal for open enrollment periodSupport and assist with all other PCP / panel type projectsNeed to request reports from health plan of all provider loads so we can do a comparison on a weekly basis just like we do for UHC
Required Qualifications:Bachelor's degree in related field or 4 additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a Bachelor's degree2+ years of experience in business analysis collecting, analyzing, and presenting data and recommendations to management4 or more years in healthcare, preferably in Provider Network OperationsIntermediate experience with Microsoft Office applications including Word, Excel, Access, and OutlookExcellent organizational, communication, and ability to multi-taskAbility to communicate effectively with varied audience Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 90,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do 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.
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.