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Senior Claims Business Process Consultant – Remote

Unitedhealth Group

This is a Contract position in Whitefish, MT posted December 13, 2021.

Youll enjoy the flexibility to telecommute from anywhere within the U.S.

as you take on some tough challenges.

Welcome to one of the toughest and most fulfilling ways to help people, including yourself.

We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement.

Join us and start doing your life’s best work.

SM Position is responsible for diagnosing process improvement opportunities across the delegated claims oversight process and developing solutions using principles of process excellence and innovative tools.

This position will also support the end-to-end delegate claims oversight process to ensure a consistent member experience for all lines of business and that all key operational performance metrics are met.

This position is full-time (40 hours/week) Monday
– Friday.

Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of (8:00am
– 5:00pm).

It may be necessary, given the business need, to work occasional overtime.

Training will be conducted virtually from your home.

All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.

Primary Responsibilities: Develop process enhancements to improve the end-to-end process for the oversight and monitoring of claims compliance of our provider delegates that have been contracted with UHC to process claims on behalf of our members.

Includes ensuring a consistent member experience to contribute to an improvement in NPS.

Provide analytical and professional support to the Delegated Claims Oversight team to ensure operational metrics are met accurately and timely.

Root cause delegated claim audit operational issues, document findings and implement action plans, including collaboration with external provider delegates.

Continual innovative development of business tools that maximize productivity and process transformation Effectively communicate the issues, including any barriers or risks to their resolution, with both internal and external parties.

Such communication may be written or verbal.

Provide appropriate subject matter expertise and business analysis for projects related to delegated claims oversight issues.

Work with over 500 providers delegated for claims processing on behalf of UHC members across all lines of business.

Youll 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: Bachelors degree (or higher) or 3years equivalent experience 3 years of experience developing and implementing business process change initiatives, including documentation 5 years of experience working with regulatory compliance or quality adherence (Medicare, Commercial and Medicaid) 2 years of experience in an operations setting with an understanding of operational metrics 2 years of experience in communication, internal and external executive level Intermediate proficiency with Microsoft office, including Word and Excel, (Create, Edit, Pivot, formulas, vLookup, run reports).

Preferred Qualifications: Experience in the Health Care industry Knowledge of Value Based Contracting or Capitated Delegated Division of Responsibility business models Experience with process improvement, workflow, benchmarking and / or evaluation of business processes Soft Skills: Highly efficient with relationship skills High proficiency in analytical skills, critical thinking, and problem analysis Intellectually curious Bias for action High proficiency in leading/driving meetings and conversations High proficiency with relationship skills Change Management experience Ability to prioritize and effectively handle multiple priorities Telecommuting Requirements: Required to have a dedicated work area established that is separated from other living areas and provides information privacy Ability to keep all company sensitive documents secure (if applicable) Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Military & Veterans find your next mission: We know your background and experience is different and we like that.

UnitedHealth Group values the skills, experience and dedication that serving in the military demands.

In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance.

Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey.

Learn more at Learn how Teresa, a Senior Quality Analyst,works withmilitary veterans and ensures they receive the best benefits and experience possible. Careers with UnitedHealthcare .

Let’s talk about opportunity.

Start with a Fortune 5 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 wherever 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 lifes best work.

SM 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, youll find a far-reaching choice of benefits and incentives 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.

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