Job Description

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

The Reporting Analyst is responsible for assisting the Delegation Support team with maintaining delegation requirements as it relates to compliance reporting, health plan audits and regulatory requirements. As a Reporting Analyst, you will partner with internal and external stakeholders to ensure all contractual obligations of delegation requirements are being met.

Primary Responsibilities:

• Assists with management of health plan and regulatory related reporting including pulling, auditing, providing feedback to applicable leadership on findings, validating any necessary updates needed and submitting reports
• Facilitates monthly, quarterly, and ad hoc Health Plan reporting requirements
• Coordinates with necessary teams across the region to assure compliance with health plan changes (Analytics/Application Support)
• Provides feedback on problem cases and interfaces with utilization management and care management teams and other personnel in resolving health plan requests, delegation changes and ad hoc reporting requests
• Works with key stakeholders to facilitate necessary report requirements updates
• Participates in health plan audits and Corrective Action Plan (CAP) closure requirements, as needed
• Assists with processing, monitoring, and data gathering and analysis of reports regarding appeal activity as well as preparing for appeals audits
• Responds to health plan inquiries regarding status, process, and outcome of authorizations and appeals or forwards inquiries to the appropriate functional area
• Performs other duties as assigned

Professional Competencies:

• Working knowledge of managed care, Medicaid, Medicare and SNP
• Working knowledge of the authorization process
• Working knowledge of PC applications including MS Office Suite
• Ability to use written and oral communication skills
• Ability to read and interpret data
• Ability to identify learning needs, set goals and seek educational opportunities
• Ability to analyze problems and formulate appropriate plans, solutions, and courses of action
• Knowledge of age specific communication needs with the ability to listen actively and respond to internal and external customers in a timely, competent manner both verbally and nonverbally
• Ability to establish and maintain cooperative working relationships with individuals at all levels of the organization and affiliates
• Ability to maintain confidentiality of patient and all related entity business matters of the organization and its partners
• Ability to manage detail and work with accuracy
• Ability to recognize and act appropriately in situations where patient care needs exceed scope of practice
• Skill in working with a team and the ability to collaborate on projects with colleagues

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:

• High school diploma/GED
• 3+ years of administrative experience with increasing level of responsibility
• 2+ years working experience, within the last 5 years, with managed care products, Federal and State regulatory requirements (i.e., NCQA, CMS, HCA); multiple care delivery systems preferred

Soft Skills:

• All staff members are to promote a positive and productive work environment by acting maturely and responsibly, satisfactorily performing his or her job responsibilities and conducting themselves in a professional, courteous and respectful manner toward fellow employees, physicians and patients
• Must hold relationships to a high standard- respectful approach to all people and interactions, listening to understand, take emotional accountability and exemplify balance of self with all interactions, be receptive to feedback and opportunities keeping an open mind towards growth
• Integrates Lean principles, practices and tools to improve operational efficiency, reduce costs and increase customer satisfaction
• Follows written and oral instructions and completes routine tasks independently.
• Completes annual compliance training on HIPAA/Privacy/Confidentiality/Non-Discrimination/Harassment/Integrity Statement and signed Agreements
• Ensures confidentiality of patient information following HIPAA guidelines and company policies
• Attends training to meet requirements of the job position and as needed or mandated by company policies and regulations
• Has regular and predictable attendance

Preferred Qualifications:

Remains in a stationary position for extended periods of time on a frequent basis

The hourly range for this role is $16.88 to $33.22 per hour based on full-time employment.. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.

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: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO #RED

Job Tags

Similar Jobs