UnitedHealth Group
Capability Manager / Rate Manager - Remote
This job is now closed
Job Description
- Req#: 2199033
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Competitive pay up to $167,300 per year
- Remote work flexibility from anywhere within the U.S.
- Comprehensive benefits package, including equity stock purchase and 401k contribution
- Chance to make a positive impact on health outcomes and address health disparities
- Incentive and recognition programs to reward performance
What to Expect (Job Responsibilities):
- Serve as primary Facility / Ancillary technical SME to assess Medicare’s Prospective Payment Systems (PPS) and ensure compliance with CMS regulatory requirements
- Create custom rate files for Optum Insight pricing and grouping software
- Model claim scenarios to test pricing requirements
- Perform user acceptance testing for PPS system changes and document results
- Collaborate with Pricing Configuration to identify quality improvement requirements and ensure flawless pricing execution
What is Required (Qualifications):
- 3+ years of Optum Insight Prospective Payment Systems pricing experience
- 3+ years of Facets / NetworX Pricing experience, preferably in provider pricing configuration role
- 3+ years of experience reading and interpreting physician/facility/ancillary contracts
- 3+ years of experience working with Medicare, Medicaid, or Commercial products
- Experience gathering and documenting business requirements, creating user stories, and developing workflows
How to Stand Out (Preferred Qualifications):
- Previous provider pricing delegation experience
- Experience with UHC Secondary Platforms (CSP Facets / COSMOS)
- Revenue Cycle Management experience
#HealthcareServices #CareerAdvancement #CompetitivePay #RemoteWorkOpportunity #PositiveImpact
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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.About the company
UnitedHealth Group Incorporated is an American multinational managed healthcare and insurance company based in Minnetonka, Minnesota.
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