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Optum, part of the UnitedHealth Group family of businesses, is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.
Roster Data Management Specialist - Remote
Location
Nevada
Posted
51 days ago
Salary
$28 - $51 / hour
Seniority
Mid Level
Job Description
Roster Data Management Specialist - Remote
Optum
Requisition Number: 2350119 Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Roster Data Management Specialist is responsible for maintaining accurate, timely, and compliant roster data across internal systems and external partners, including payers and regulatory entities. This role serves as the authoritative owner of roster data and plays a critical role in ensuring provider readiness, minimizing claim denials, and supporting operational and financial performance. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Roster Data Governance & Integrity - Maintain master roster records for providers, facilities, and affiliations - Ensure data consistency across credentialing, enrollment, EHR, and payer systems - Enforce required data standards, naming conventions, and documentation requirements - Conduct routine and ad hoc audits to identify discrepancies, duplicates, or missing data - Maintain version control and audit trails for roster submissions and updates Roster Submissions & Payer Management - Prepare, validate, and submit roster files to payers and external entities - Monitor submission status, acknowledgments, approvals, and rejections - Resolve payer feedback related to effective dates, locations, specialties, or network status - Serve as the primary point of contact for payer roster-related inquiries and escalations Change & Lifecycle Management - Process provider and facility adds, terminations, transfers, and demographic updates - Coordinate effective dates to align with credentialing, contracting, and enrollment milestones - Ensure roster updates are implemented timely to support go-lives and billing activities Cross-Functional Collaboration - Partner with Credentialing, Provider Enrollment, Provider Relations, Revenue Cycle, and Compliance teams - Support claims and billing teams by researching and resolving roster-related denials - Proactively communicate roster risks that may impact revenue, provider activation, or compliance - Manage Provider Data Management Shared Inbox - Create, update and maintain department job aids Reporting & Continuous Improvement - Track roster submission cadence, payer SLAs, and resolution timelines - Identify trends, recurring issues, and root causes of roster discrepancies - Develop reports or dashboards to support leadership visibility and decision-making - Recommend process improvements to reduce errors and improve efficiency - Complete reporting requests for internal and external requirements Compliance & Audit Support - Ensure roster data complies with payer contracts, CMS requirements, and state regulations - Support internal and external audits by providing documentation, submission history, and reconciliations - Escalate compliance risks related to incomplete or inaccurate roster data 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 provider enrollment, credentialing, roster management, or healthcare operations - Solid understanding of payer enrollment workflows and provider lifecycle management - High attention to detail with experience managing complex datasets - Proficiency with Excel and healthcare platforms such as MD-Staff, CAQH, Availity or any other payer portals Preferred Qualifications: - Experience supporting multi state provider networks or high volume rosters - Familiarity with CMS, Medicaid, Medicare, and commercial payer requirements - Experience partnering with Revenue Cycle to resolve claim denials - Reporting or dashboard development experience *All employees working remotely 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 $28.94 to $51.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 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.
Benefits
- 401(K), Dental insurance, Disability insurance, Employee stock purchase plan, Family medical leave, Flexible Spending Account (FSA), Generous parental leave, Generous PTO, Health insurance, Job training & conferences, Life insurance, Charitable contribution matching, Paid holidays, Paid sick days, Performance bonus, Tuition reimbursement, Vision insurance, Mental health benefits, Personal development training, Bereavement leave benefits
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