If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work. This role will manage operations for an ASO contract for the State of South Carolina. The state is engaged in a Medicaid Enterprise System (MES) modernization effort to improve efficiency and effectiveness of program administration. The intent is to implement a services based solution, and to seek enabling technology to that end. The role is accountable for development, implementation and operations of a program to bring together three functional work streams. These include Medicaid Operations, Clinical service including utilization management and quality reviews, and Fee for Service (FFS) Claim processing. The role will be located in the OPTUM Government Services Center in Atlanta, Georgia. Relocation may be available for a well qualified candidate.
Required Qualifications: 6+ years of experience with account management or leadership for a government or private sector health care payor; or comparable experience within a health and human services agency or State Medicaid entity2+ years of experience with leadership of a large scale integrated claims processing system3+ years of experience working with Medicaid programs / processes, including a familiarity with Fee for Service (FFS) processingAt least an Intermediate level of proficiency with MS ExcelPreferred Qualifications:Excellent verbal and written communication skills; ability to speak clearly and conciselyExperience achieving results through teamwork and involving multiple departments\Strong interpersonal skills, establishing rapport and working well with othersProblem solving and analytical skills; the ability to systematically analyze data and draw relevant conclusions and devise appropriate courses of actionSuperior organization skills and attention to detailAbility to quickly learn new applications and systems with trainingMasters' degreeCareers with OPTUM. Here's the idea. We built an entire organization around one giant objective; make the health system 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.SMDiversity 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. Job Keywords: Operations Manager, claims processing, Fee for Service (FFS) processing, MS Excel, Atlanta, GA, Georgia, Alabama, South Carolina, Texas
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.