Delegated Credentialing Oversight Analyst - Remote
Company: UnitedHealth Group
Location: Minnetonka
Posted on: May 31, 2025
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Job Description:
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 equitable.
Ready to make a difference? Join us to start Caring. Connecting.
Growing together.
You'll enjoy the flexibility to work remotely * from anywhere
within the U.S. as you take on some tough challenges.
Primary Responsibilities:
In compliance with the organizations' established methodology,
conduct delegated credentialing audits in accordance with standard
operational, regulatory, accreditation and compliance processes and
procedures
Provides guidance, remediation, and post follow-up outcomes
communication to mitigate operational risk of repeat corrective
action plans, fines and/or penalties from regulators
Manage the end-to-end oversight responsibilities for delegated
credentialing
Drive consistent and efficient processes to support the management
of all delegated credentialing audit activities
Analyze and investigate, problem resolution; defining and
recommending action items for the delegated group; evaluating
outcomes and providing ongoing feedback to appropriate delegate and
internal staff/committees; providing support at Regulatory and
Accreditation surveys, as needed
Communication, flexibility, credibility, and the ability to
interpret accreditation and regulatory requirements and delegated
entity policies to ensure accurate implementation of processes are
the key drivers needed in this role to establish and sustain the
delegated relationship, learn about their environment and help
customers understand United's delegated credentialing model
A Day in the Life: Clinical Quality Analyst
Log into the computer, review daily calendar, and check email/voice
messages
Prioritize daily work utilizing critical thinking skills
Participating in monitoring activities
Provide support and guidance to team members as needed
Organize, request, and follow up on audit material to be collected
from external stakeholders
Perform reviews of delegate's policies, procedures and
credentialing files to assure compliance
Attend necessary meetings and/or training sessions
Attends meetings with provider groups to assess eligibility for
participation in the delegated oversight process
Actively participate in projects by attending meetings, gathering
information, analyzing data and other assigned tasks
Share ideas and techniques for best practices with team and
leaders
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:
3+ years of experience in credentialing (i.e. Providers) and/or
delegation oversight auditing
Proven effective written and verbal communications and analytical
skills
Proven ability to be self-motivated, independently solve problems
and apply critical thinking strategies
Proven solid conflict management and negotiation skills
(discrepancies found during audits)
Proficient computer skills - Microsoft Windows, Word, Outlook,
Excel & PowerPoint, and Adobe PDF
Preferred Qualifications:
Proven effective written and verbal communications and analytical
skills
Proven ability to be self-motivated, independently solve problems
and apply critical thinking strategies
Proven ability to work autonomously
Proven detail orientated with focus on quality/quality
assurance
Proven ability to respond quickly to new instructions, situations,
methods, and procedures
Proven ability to manage competing demands on time
Skills You Will Develop:
Assess and interpret customer needs and requirements
Identify solutions to non-standard requests and problems
Ability to work in an ever-changing, fast-paced environment while
maintaining a flexible approach to managing tasks and fulfilling
responsibilities
Ability to use constructive criticism/feedback to improve skills
and work processes
*All employees working remotely will be required to adhere to
UnitedHealth Group's Telecommuter Policy
The hourly range for this role is $28.61 to $56.06 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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