Consultant, Health Management & Operations - Claims - Telecommute - 2022798

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

Bring your analytical and consulting experience to help improve claims management, including:

Claim intake, including mailroom, EDI and clearinghouse functions

Claims processing, adjudication and payment

Claim editing and auditing

Appeal and Grievance processes

Encounter data management

Coordination of Benefits, Third Party Liability and subrogation processing

Fraud, Waste, Abuse and Error

Operations performance management

Business reporting and analytics

Core administrative systems and supporting applications or services

Other related operations functions, including benefit plan design and configuration, group and member enrollment, provider network, customer service, utilization management, finance and others

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

Primary Responsibilities:

Effectively build and maintain relationships with clients and co-workers

Conduct research studies that may include collecting, analyzing, trending and presenting data and recommendations to management

Collaborate with business and technology teams to identify issues, establish objectives, develop recommendations and implement solutions for our clients

Develop business strategies, plans and cost benefit analyses

Support client implementations of products and/or services

Provide work stream/project oversight, manage and track issue resolution and make key decisions for the project with the project sponsor

Create written and oral communication artifacts that effectively summarize findings, support fact-based recommendations and provide appropriate detail to substantiate conclusions

Drive/participate in presentations and meetings with all levels of the organization

Facilitate status updates and review of programs to client senior leadership team and/or project sponsor(s)

Drive outcomes with and without direct authority, engaging team members in a cross-functional environment

Provide coaching and mentoring of project team with the goal of developing and retaining talent within the organization

The consulting environment is challenging and fast-paced, requiring the following core competencies:

Self-Motivated/Ambitious – Highly self-motivated and ambitious to ensure all projects are successful

Critical Thinking / Problem Solving – Dig into challenging situations, synthesizing information to provide guidance and recommendations to clients

Adaptability – Flex in response to changes and maintain focus

Creativity and Persuasiveness – Uncover and respond to business needs, define solutions, and educate constituents; be known by others as a trusted advisor

Personal Accountability – Model strength during challenges and take personal responsibility for actions and consequences

Executive Presence – Articulate and package communications in a clear and crisp manner for all levels of the organization with the ability to adapt approach and style to any audience

Organization – Apply best practices for planning, executing and controlling work to maximize outcomes and value

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:

Bachelor’s degree or equivalent work experience

2+ years of relevant work experience

1+ years of experience in operational business process improvement, business process analysis, benchmark analysis, workflow analysis or data analyais

1+ years of supporting consulting engagements or similar projects/programs

Ability to work in complex, fast-paced environments

Proven experience in data analysis or financial analysis

Project coordination and management skills – strong project tracking, presentation and reporting skills

Experience writing and developing client facing materials in Microsoft Word, PowerPoint, Excel, Visio and Project

Ability to travel up to 80%; travel is required for this role and is generally less than 50% on average but may involve Monday through Thursday travel for short periods to satisfy specific client project requirements

Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance.

Preferred Qualifications:

Experience in health plan operations, including group setup, member enrollment, provider network, utilization management, claims finance and others

Experience across multiple health plan lines of business, including Commercial, Medicare, Medicaid, Exchange and Individual/Family coverage

Prior work experience in a professional consulting organization

Experience in large, matrixed environment

Solid interpersonal and communication skills

Proven analytical problem-solving skills (identification of issue, causes, solution, implementation plan)

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

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

Colorado, Connecticut or Nevada Residents Only: The Salary range for Colorado residents is $64,800 to $116,000. The Salary range for Connecticut/Nevada residents is $71,400 to 127,400. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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