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.(sm) Primary Responsibilities: Manages and resolves issues with business partners, including, but not limited to, claims, business solutions, configuration, call centers, appeals, enrollment and other functional areas as assignedIdentifies and monitors trends, and develops and implements remediation and corrective action plansManage vendors delegated to perform specific plan operationsPrioritize projects and issues, based on Plan needDevelop and implement tools for monitoring and evaluating performance objectives and complianceHelps drive innovation in healthcare and service deliveryManages regulatory and operational reports submissions, reviews and analysesFacilitates Plan requirements with corporate initiatives; promote Plan concerns and enhance communications between respective business ownersPartners and supports leadership across the health plan on assigned projects ensuring company goals and initiatives are metManages team performance, career progression, training and development and day to day performance objectives and productivity
Required Qualifications:Bachelor's degree or equivalent experience3 plus years of experience in healthcare and/or managed health care operations1 plus year(s) of management experience Good organizational and project management skillsStrong communication skills, both written & verbalDetailed oriented with good problem solving skillsProficiency with MS Office, Word, PowerPoint & ExcelOccasional light travel, mostly intrastatePreferred Qualifications:Six Sigma and/or Project Management certificationExperience with claims and/or claims operationsCareers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)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.
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.