Value-based Risk Management – Sr Capability Analyst – Telecommute

UnitedHealth Group
April 7, 2021
Atlanta, GA
Job Type


UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

The Strategic Claims Capability (SCC) is a small team of professionals dedicated to solving problems, driving improved performance and leading change across all UnitedHealth Group’s business segments in an objective, provocative, and accountable way. We bring substantial and diverse health care, strategic and operational consulting, business development, program management and change leadership expertise to the table. We also deliver on some of the most complex programs that require an enterprise mindset.

The SCC team partners with executives and their teams on engagements to drive meaningful change. Projects focus across a range of the Enterprise’s most pressing issues, including business model transformation, service improvement, new services and products, administrative cost containment, and platform simplicity. Our team members help to resolve complex issues, identify new opportunities, and quickly drive results by applying strategic insight, intellectual honesty, and analytical structure. This approach, when joined with the deep knowledge of the business provided by segment personnel, enables a comprehensive approach to support some of the organization’s most critical strategic programs impacting claim.

SCC team members can expect to be exposed to a wide variety of topics and situations across multiple segments and business functions. The environment is challenging and fast-paced, requiring flexibility in delivering against assigned tasks and ability to work in diverse areas of healthcare. Team members are expected to have a high level of energy, a passion for driving value and making a positive impact both within and beyond UnitedHealth Group, and have an ability to think in an innovative manner. Finally, SCC leaders take talent development seriously, and expect a successful tenure with the team to be a great path to even greater leadership opportunities across the UHG enterprise.

This role requires alignment to business and product strategy, effective design and development, and ongoing management of capabilities for Capitation, Claims Delegation and Encounters. You will be accountable for delivering sustainable, financially sound solutions that solve a specific problem and enable successful external product delivery and/or internal business function performance, while driving adoption with internal business clients and define future capability direction that supports business strategy and new opportunities.

Value-based Risk Management includes the capabilities of capitation, claims delegation and encounters management. The selected candidate will be a key leader in helping to lead the development of this capability/set of initiatives according to the Value-based Risk Management roadmap.

You’ll enjoy the flexibility to telecommute* from anywhere within United States as you take on some tough challenges.

Primary Responsibilities:
  • Lead and / or support program / Claims initiatives under the Value-based Risk Management program
  • Deliver of components of the capability / program
  • Ensure alignment and understanding of program / project scope and objectives with the organization's strategic objectives, in consultation with applicable stakeholders
  • Coordinate with SMEs to address task sequencing and to help obtain information necessary to each team
  • Facilitate and manage workgroups, enabling a culture of collaboration, trust and disciplined accomplishment of tasks and target dates
  • Establish, develop and maintain effective relationships with applicable project stakeholders including but not limited to project team members, delegated entity teams, internal customers, functional SMEs, business partners, leadership
  • Document and groom business requirements/solution capabilities for projects requiring technology changes, with ability to elicit, understand and articulate customer needs
  • Primary to work with Architects on solution intent
  • Acts as a resource for others; readily shares knowledge
  • Ensures operations is protected e.g. drives solutions that do not require significant adds to staffing, influences direction away from approaches and strategies that Operations cannot administer
While you’re busy helping us change the landscape of health care, you’ve got to be able to quickly adapt to change in a fluid environment. It's all about quality reporting, analysis and audits and developing plans and programs to support continuous quality improvement.

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:
  • 1+ years of project management, business analysis and or product management experience within medical claims and payment
  • Experience with COSMOS, NICE, CSP Facets or other medical claims system platforms including delegation of financial responsibility (DOFR) functionality
  • Experience with claims delegation, encounter or capitation platforms 
  • Demonstrated experience with process improvement, workflow, benchmarking and / or evaluation of business processes
  • Demonstrated experience in gathering and evaluating requirements and also writing and translating business requirements
  • Intermediate level of experience with Microsoft Office products, such as Excel or Visio
  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders
Preferred Qualifications:
  • Bachelor’s degree in Business, Finance, Health Administration or related field required, advanced degree
  • Experience with Agile methodology
  • Experience supporting decision-making activities by senior level business stakeholders 
  • Strong working knowledge of how to execute on project deliverables in a fast-paced environment 
  • Ability to develop strong networks and ensure collaboration and consensus building
  • Ability to communicate complex issues to diverse audiences
  • Intellectually curious
  • Bias for action
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 7 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)

Colorado Residents Only: The salary range for Colorado residents is $64,800 to $116,000. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary,  UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.


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

Job Keywords: UHC, Unitedhealth Group, Telecommute, Sr. Capability Analyst, Claims Delegation, Encounter, Capitation Platforms, Project Manager, PM, PO, Business Analyst, Telecommute, Telecommuting, Telecommuter, Work From Home, Remote, Chicago, Illinois, IL, Hartford, Connecticut, CT, Tampa, Florida, FL, Denver, Colorado, CO, Cypress, California, CA Seattle, Washington, WA
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