Data Steward Specialists are responsible for various research and loading activities related to the C&S provider network database with direct load maintenance into CSP Facets platform. Data Stewards conduct research and make informed decisions to deliver quality results. They are responsible for conducting proper research through various tool and initiating requests to properly maintain the provider data housed in our core systems to allow for proper state reporting, claim payment, member assignment and directory information.
You’ll enjoy the flexibility to telecommute* from within the U.S. as you take on some tough challenges.
Positions in this function are responsible for various activities related to the provider network database which may include any or all of the following:
- Database maintenance, reporting and extracting data for various reports and analysis.
- Develops and maintains standards for database integrity and quality assurance
- Coordinates corrective activities to maintain system sync efforts between NDB and CSP
- Manages communication processes with other departments
- Identify opportunities to improve processes and performance
- Maintains current provider data to ensure the quality of the network. May be responsible for representing the provider network area on company IT projects, reporting and tracking provider calls and complaints, or for the support, coordination, and production of the paper directory cycles.
Primary Responsibilities:
- Receive data from multiple inbound sources (e.g. Special Projects, Rosters, Control Reporting, Escalations, FST, spreadsheets & email) and conduct proper research to initiate update/change requests to provider data within CSP Facets
- Utilize multiple database systems and tools to enter and/or research provider data to pull in the correct or needed information (e.g., PhyCon, CAQH, CSP Facets, NDB, Impact, CORE, PLMI, etc.).
- Review system results to determine whether keyed data is correct or updates are necessary.
- Contact internal or external data submitter to verify/clarify information and/or data to be entered, when required.
- Maintain current knowledge of business strategies, rules, and procedures (e.g., attend training).
- Demonstrate an understanding of and apply business strategies, rules, and procedures as appropriate (e.g., determine whether to reject or accept data prior to entry).
- Participate in applicable ad hoc projects, as assigned
- Conduct a full system End to end review on provider installation and administration of assigned tasks
- Uses pertinent data and facts to identify and solve a range of problems within area of expertise.
- Investigates and analyzes non-standard requests and problems, with some assistance from others.
- Consistently meet target production, quality, and time utilization metrics.
- Develop and maintain productive work relationships
- Prioritize and organize own work to meet deadlines
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
- 1+ years experience in the healthcare industry.
- 1+ years of data entry experience.
- 1+ years experience in medical claims processing.
- Intermediate level of proficiency with MS Office suite
- 1+ year customer service experience
Preferred Qualifications:
- Experience working in an environment that included having accountability for meeting metrics
- Experience with dual monitor environment
- Demonstrated communication and organization skills
- 1+ year(s) experience with provider data (demographic and/or contractual)
- 1+ year(s) experience with quality programs and process improvement initiatives
- 1+ year(s) experience with claims processing systems such as COSMOS, UNET and/or CSP
- 6+ mo experience with workforce effectiveness practices
- Experience in NDB
- Experience in Provider Data Operations workflow tools (PhyCon, CORE, etc.)
- Proficiency with medical terminology preferred
Careers with UnitedHealthcare. Let’s talk about opportunity. Start with a Fortune 5 organization that’s serving more than 85 million people already and building the industry’s singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they’re found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that’s second to none. This is no small opportunity. It’s where you can do your life’s best work.(sm)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.