At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start
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Provider Data Analyst is a key member of the Provider Data Management team, responsible for maintaining the accuracy, integrity, and quality of provider data across enterprise systems. This role serves as the subject matter expert for provider demographic, ensuring that provider records are complete, accurate, and compliant with internal standards and regulatory requirements.
The Provider Data Management team is responsible for managing the full lifecycle of provider data, including provider onboarding, demographic updates, contract maintenance, roster management, terminations, audits, and data quality initiatives. The Provider Data Analyst works closely with Credentialing, Claims, Customer Service, Provider Relations, Finance, Network Management, and external providers to ensure provider information is accurately reflected throughout all systems and downstream processes.
This position plays a critical role in supporting provider network operations by researching and resolving provider data discrepancies, conducting data validation and quality assurance reviews, maintaining provider databases, processing provider updates and terminations, and supporting claims resolution activities resulting from provider data issues. The role also contributes to reporting, regulatory compliance, system enhancements, and process improvement initiatives designed to improve data accuracy and operational efficiency.
Through proactive data management, analysis, and collaboration with cross-functional partners, the Provider Data Analyst helps ensure the integrity of the provider network, supports accurate claims processing and provider payments, and contributes to a positive provider experience
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:- Maintain accurate and compliant provider demographic, contract, and location data across enterprise systems
- Process provider additions, updates, disclosures, roster changes, and terminations through Salesforce and other internal applications
- Generate, validate, and distribute provider rosters, demographic verification reports, and client/regulatory reporting
- Perform data audits, quality reviews, and provider demographic verification to ensure data integrity and compliance
- Research and resolve provider data issues impacting claims, payments, and customer service, including provider verification requests and claims reprocessing
- Investigate and resolve provider payment issues, including returned checks, billing address discrepancies, and levy requests
- Collaborate with Claims, Credentialing, Customer Service, Finance, and Network Management teams to support provider data accuracy and operational effectiveness
- Develop reports, support process improvement, and system enhancements
- Support administrative functions, workload coordination, and shared team responsibilities to ensure timely completion of provider data activities
Systems and Tools:- Salesforce
- EyeManager (EM)
- NPPES NPI Registry
- IRS Tax Matching Tools
- UltraEdit
- SharePoint
- Microsoft Excel
- Microsoft Word
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications: - 2+ years of managed care, healthcare administration, medical insurance, or provider operations experience
- 1+ years of experience in provider data management, claims, customer service, credentialing, or provider support
- 6+ months of experience working with provider rosters, demographic data
- 6+ months of experience in researching and resolving complex provider or claims-related issues
- Advanced level of verbal and written communication skills with professional telephone etiquette
- Intermediate level of proficiency with Microsoft Office applications, including Excel and Word
Preferred Qualifications: - Ability to work independently while managing multiple priorities and meeting deadlines
- Strong organizational, analytical, and problem-solving skills
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $24 - $43 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
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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