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Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)At Optum, our mission is to create a healthier world. Each day we strive to create a health care system that works better for all of us. As a Senior Consultant in our Optum Advisory Services Health Management & Operations practice, you'll provide consulting services to help our payer and provider clients optimize and transform their business operations to achieve their most important goals.Bring your operations/technical skills, deep domain expertise and management consulting experience to help transform health plan operations, including:Case installation, benefit configuration and group setup
Member eligibility, enrollment, file transfers and fulfillment
Billing, collections, and financial reconciliation
Claim intake, including mailroom, EDI, and clearinghouse functions
Claims processing, adjudication, and payment
Appeal and Grievance processes
Encounter data management
Coordination of Benefits, Third Party Liability, and subrogation processing
Payment integrity, including fraud, waste, abuse, and error
Operations performance management
Business reporting and analytics
Core administrative systems and supporting applications or services
Other related operations functions, including provider network and data management, customer service, utilization management, finance, and others
Creating and loading SQL tables, SQL query creation and creating complex joins
Requirements gathering, including data mapping process for client file intake into core Optum systems
Solid understanding of Database Management with SQL server
Ability to explain technical information in a way that establishes rapport, persuades others, and fosters understanding
You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:Effectively build and maintain relationships with clients and co-workers
Create, load, maintain and query SQL databases for client engagements
Conduct research that may include collecting, analyzing, trending and presenting data and recommendations to management
Collaborate with business and technology teams to identify issues, establish objectives, develop recommendations, and implement solutions for our clients
Develop business strategies, plans and cost benefit analyses
Support client implementations of products and/or services
Perform data compares and reconciliations using multiple data sources
Advanced knowledge of MS Excel, Access and other productivity tools
Provide work stream/project oversight, manage, and track issue resolution and make key decisions for the project with the project sponsor
Create written and oral communication artifacts that effectively summarize findings, support fact-based recommendations, and provide appropriate detail to substantiate conclusions
Drive/participate in presentations and meetings with all levels of the organization
Facilitate status updates and review of programs to client senior leadership team and/or project sponsor(s)
Drive outcomes with and without direct authority, engaging team members in a cross-functional environment
Provide coaching and mentoring of project team with the goal of developing and retaining talent within the organization
The consulting environment is challenging and fast-paced, requiring the following core competencies:
Self-Motivated/Ambitious - Highly self-motivated and ambitious to ensure all projects are successful
Critical Thinking / Problem Solving - Dig into challenging situations, synthesizing information to provide guidance and recommendations to clients
Adaptability - Flex in response to changes and maintain focus
Creativity and Persuasiveness - Uncover and respond to business needs, define solutions, and educate constituents; be known by others as a trusted advisor
Personal Accountability - Model strength during challenges and take personal responsibility for actions and consequences
Executive Presence - Articulate and package communications in a clear and crisp manner for all levels of the organization with the ability to adapt approach and style to any audience
Organization - Apply best practices for planning, executing and controlling work to maximize outcomes and value
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:Bachelor’s degree or 4+ years additional equivalent experience
3+ years of relevant work experience
2+ years of experience working in a claim operations management role at a health plan
2+ years of experience in operational business process improvement, business process analysis, benchmark analysis or workflow analysis
1+ years of experience leading consulting engagements or internal healthcare projects/programs
Experience writing and developing client facing materials in Microsoft Word, PowerPoint, Excel, Visio and Project
Proven experience in data analysis and financial analysis
Travel is required for this role and is generally less than 50% on average but may involve Monday through Thursday travel for short periods to satisfy specific client project requirements
Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
Preferred Qualifications:Experience in Digital process enablement and transformation
Experience in large, matrixed environment
Work experience in a professional consulting organization in a healthcare operations leadership role
Broad experience in health plan operations, including group setup, member enrollment, provider network, utilization management, finance and others
Health plan experience across multiple lines of business
Ability to work in complex, fast-paced environments
Solid interpersonal and communication skills
Proven analytical problem-solving skills (identification of issue, causes, solution, implementation plan)
Project coordination and management skills - solid project tracking, presentation, and reporting skills
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employmentCareers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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.(sm)Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $82,100 to $146,900. The salary range for Connecticut / Nevada residents is $90,500 to $161,600. 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, you’ll find a far-reaching choice of benefits and incentives.All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.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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