Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
The Capitation Configuration Analyst is responsible for managing and configuring capitation agreements within Facets platform. This role requires a thorough understanding of capitation models, healthcare industry practices, and data analysis to ensure accurate payment processing and compliance with contractual terms.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Capitation Configuration: Set up and maintain capitation agreements in the Facets processing system, ensuring accuracy and adherence to contractual terms
Data Analysis: Analyze capitation data to identify trends, discrepancies, and areas for improvement. Provide recommendations based on data findings
Compliance: Ensure capitation agreements are compliant with healthcare regulations and standards. Stay updated on changes in regulations and adjust configurations accordingly
Reporting: Generate reports on capitation payments, performance metrics, and compliance status. Present findings to stakeholders
Collaboration: Work closely with other departments, such as finance, provider relations, and IT, to ensure seamless capitation processes and resolve any issues
Documentation: Maintain thorough documentation of capitation configurations, processes, and changes. Ensure records are accurate and accessible
Training: Provide training and support to staff on capitation processes and system use
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:
5+ years of experience in capitation configuration, claims administration, healthcare data analysis, or related roles
Understanding of healthcare regulations, capitation models, and payment processes. Familiarity with data analysis tools and methodologies
Solid analytical skills, attention to detail, and proficiency in healthcare management systems. Excellent communication and collaboration skills
Proven flexibility and a HIGH tolerance for ambiguity
The nature of the work is we are establishing a new area and capabilities for the Optum Health team. As such, we are building new processes not necessarily done before, things are not documented, and there is no formalized training. We need people who can dive in, learn, adapt, and perform quickly
Preferred Qualifications:
Facets configuration knowledge
Proven ability to make independent decisions on behalf of the team by applying critical thinking skills without always having all the information
Exemplary team skills and demonstrated ability to be a positive and productive team member. With the transformative nature of the work we are doing, we need someone who can be a team player due to the levels of collaboration involved
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
The hourly range for this role is $34.42 to $67.60 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.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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