For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Utilize knowledge of benefit plans and documents to gather details to create/update applicable product configuration elements Collaborate with stakeholders to gather, assess, interpret and document customer needs and requirements Design, configure and build various product / benefit components in Facets with emphasis on BPA Research claims issues to determine configuration gaps, update configuration as applicable Audit configuration against benefit plan requirements / EOC, etc., verify configuration following source documentation Acts as a SME to other team members to answer questions and coaches on opportunities Consistently meet established productivity, schedule adherence, and quality standards while maintaining expected attendance Represent benefit configuration in business partner meetings as a SME to research and respond to action items Facilitate meetings to partner with others on issue resolution and problem solving including follow up on action items as needed
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 working with Medicare and/or Commercial plan benefit configuration, claims issue resolution or other areas of Facets configuration 3+ years of experience working with Facets database tables and configuration Proficiency in Microsoft Word, Excel, and Outlook Demonstrated excellent oral and written communication skills Demonstrated ability to work in a fast-paced, dynamic, rapidly changing environment Proven self-starter and able to work independently Proven ability to constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance
Preferred Qualifications:
2+ years of health insurer experience with medical plan case installation or benefit plan building 2+ years of health insurer experience handling provider billing/co-payments/co-insurance 2+ years of health insurer experience resolving provider claim issues 2+ years of experience working with BPA and/or Workflow Experience with Medicaid, Medicare or Commercial medical benefit plans Experience with COSMOS or UNET or NICE Experience building and running SQL queries using tools such as MS Access, Query Builder, or similar Understanding of claims Workflow routing, queues, and roles Knowledge of supporting tools from Trizetto and other vendors such as CMU or similar applications
Soft Skills:
Interpersonal Skills - ability to deal and work with people with different backgrounds. Demonstrated ability to build and maintain long term internal business relationships Decision-Making Skills - capable of arriving at the appropriate decisions after weighing the pros and cons of all the options Communication Skills - excellent verbal and written communication skills in addition be a good listener to give value to the opinion and suggestion of others Accountability - Takes ownership of tasks, performance standard and quality results. Maintains necessary attention to detail to achieve high level performance Problem Solving - Solution Driven Approach Skills - demonstrate ability to review problem, troubleshoot root cause issues and determine path to resolution Flexible - Able to work effectively in a changing environment and contribute innovative ideas Accuracy and Efficiency - Excellent time management and organizational skills balancing multiple priorities. Accurate when processing detailed tasks while meeting deadlines Self-starter - able to independently, drive work and prioritize work with minimal oversight
California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The hourly range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $32.60 to $63.99. 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.
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
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.
Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment