Senior Recovery Resolution Analyst

Número de la requisición: 2306616
Categoría de la vacante: Business & Data Analytics
Ubicación: Sacramento, CA

Doctor consulting nurse at nurse station.

Trabajos con UnitedHealth Group

Estamos creando oportunidades en cada rincón del mercado de salud para mejorar vidas mientras construimos carreras. Y eso significa oportunidades de crecimiento profesional continuo para usted. Mientras le apoyamos con las últimas herramientas, capacitación avanzada y la fuerza unida de los compañeros de trabajo de alto calibre, usted puede continuar siguiendo el camino del mejor trabajo de su vida. SM

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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The health care system needs to evolve even further than it has, and it must do so at a lightning-fast pace. New models of care and networks of providers are emerging now to better serve patients and communities, and at UnitedHealth Group, we are playing a lead role.  As a Recovery Resolution Analyst Sr within our Coordination of Benefits team, you will support the growth of our markets and membership.  In return, you’ll discover the impact, resources, backing, and opportunities that you’d expect from a Fortune 5 leader.

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

Primary Responsibilities:

  • Operations Excellence: Process Improvement, Root Cause Analysis, Automation, Data Exchange, Reporting & Dashboard Ideation, Tech Strategy, Process Controls, Workflow Oversight, and Compliance & Regulatory Validation

  • Vendor Accountability: Growth & Expansion, Vendor Contracting & Management, and Invoice Approvals

  • Vendor Operations: Vendor SLA Adherence, Formal Root Cause Analysis and Presentation, and Invoice Reconciliation

 

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:
*    5+ years direct Coordination of Benefits experience
*    5+ years in formal analysis including structured problem solving
*    5+ years of experience in root cause analysis, cost benefit analysis
*    Knowledge of NAIC and Medicare guidelines
*    Proven ability to lead and complete E2E implementations using DMAIC process
*    Proven ability to lead and influence business partner and vendor meetings and relationships
*    Intermediate Office (Excel, PowerPoint, Visio) experience
*    Proven ability to regularly shift large priorities while maintaining deadlines
*    Proven to have independent problem-solving skills
*    Proven to be detail-oriented; ability to identify all possible outcomes and scenarios ahead of automation development

 

Preferred Qualifications:
*    5+ years of Community and State (C&S) Coordination of Benefits experience 
*    5+ years of Employer and Individual (E&I) Coordination of Benefits experience 
*    5+ years of Medicare and Retirement (M&R) Coordination of Benefits experience 
*    Facets, EZCap, IDX, and/or Epic Tapestry platform knowledge and experience 
*    CA DHCS knowledge 
*    ECG connection development

 

*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 hourly pay for this role will range from $28.27 to $50.48 per hour 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.

 

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.

#RPO

Información adicional sobre la vacante

Número de la requisición 2306616

Segmento de negocio OH Risk Ops & Ent Clin Srvcs

Nivel del cargo Individual Contributor

Disponibilidad para viajar No

País US

Estado de horas extras Non-exempt

Vacante de teletrabajo Yes