Director National Claims

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

 

Purpose of Job: The Director of Notional Claims will lead and provide expertise in claims support, overseeing teams responsible for claims processing and adjustments. This role involves researching and investigating claims, authorizing payments, and referring claims for further review as necessary. 

 

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

 

Primary Responsibilities: 

• Research, identify, and gather data to process claims and resolve issues
• Ensure correct benefits are applied to each claim
• Identify and apply knowledge of new plans/customers for relevant claims processing
• Resolve claims processing errors and communicate with stakeholders using clear, simple language
• Achieve performance metrics including service level agreements and productivity
• Utilize systems, platforms, and appropriate documentation to process claims efficiently
• Use appropriate procedures and training resources to ensure accurate claims processing and compliance with relevant laws and regulations
• Collaborate with business partners to address issues, develop, and document new claims processes and solutions
• Demonstrate and update knowledge of product/service offerings and benefit plan provisions to ensure accurate claims processing and clear communication
• Apply knowledge to process claims appropriately and communicate the value of products/services to relevant audiences
• Identify opportunities to improve claims processing efficiency, reduce rework, and provide consulting and support to colleagues
• Enhance claims processing workflows by collaborating with operational partners and identifying training opportunities

 

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: 

• 10+ years of experience in leading financial services or healthcare claims departments
• Track record of having led multifunctional operations teams
• Demonstrated ability to present ideas to senior leaders, operational staff, business partners, and technical teams

 

Preferred Qualifications:

• 10+ years of experience in the Notional business in an operational role
• Experience working large multinational, matrixed organizations to accomplish complex projects
• History of leading AI and automation process improvement efforts
• Experience in using analytics-based approaches to prioritize and guide work

 

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy 

 

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $132,200 to $226,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.

 

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

 

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.   

 

 

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

 

UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.