You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.At UnitedHealthcare , we’re simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life’s best work. SMThis position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am – 5:00pm CST. It may be necessary, given the business need, to work occasional overtime or weekends.We offer 2 weeks of paid training. The hours during training will be 8:00am – 5:00pm CST.All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.Primary Responsibilities:
Execute the build and implementation of benefit plan adjudication rules
Coordinate the integration or conversion of new clients and / or products as needed, often under aggressive timelines
Participate in the development and implementation of an enterprise claim platform, providing subject matter expertise on the system configuration and usability components
Align operational needs with technology requirements
Develop best practices and standard operational procedures for creating and configuring benefit plans
Establish consistency and standardization as it relates to tools and processes (deliverable templates, change management processes, business models, process flows, etc.)
Curate a robust testing suite that is representative of all coverage to better quantify the impact of introducing configuration changes.
Ability to execute testing to ensure the accurate configuration of business requirement
Analyze issues / defects and debug the system when configuration is not producing the expected results
Partner with claim processors, member service and provider service to identify and resolve issues related to the plan configuration
Perform other duties as assigned
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:
High School Diploma / GED OR equivalent work experience
Must be 18 years of age OR older
3+ years of business / operations experience in a health plan environment
3+ years of experience with ICD - 10, CPT, HCPCS, revenue codes, and medical terminology
3+ years of experience in a healthcare environment with HIPAA, ERISA, and ACA requirements
3+ years of experience with using Microsoft Excel and SQL (creating, editing, and saving worksheets)
Experience with assisting in the plan build / plan configuration of claim adjudication platform
Experience with AGILE project methodology (requirements, design, development, testing, and implementation), inclusive of Scrum and Kanban
Ability to work any 8-hour shift between the hours of 8:00 AM - 5:00 PM CST (Central Standard Time) including the flexibility to work occasional overtime and weekends based on business need
Preferred Qualifications:
Knowledge of commercial health plan design
Telecommuting Requirements:
Required to have a dedicated work area established that is separated from other living areas and provides information privacy
Ability to keep all company sensitive documents secure (if applicable)
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Soft Skills:
Strong problem - solving skills
Accurate and precise attention to detail
Self - directed with the ability to influence without direct control
Clear, concise, engaging, and effective written and oral communication
Excellent analytical skills with ability to read and understand complex data and make thoughtful, articulate recommendations
Working in an ambiguous and fast - paced environment
Agile, ready to change direction on the fly
Ability to understand complex business processes that cross many functional operational units
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington or Rhode Island Residents Only: The hourly range for California / Colorado / Connecticut / Hawaii / Nevada / New York / New Jersey / Washington / Rhode Island residents is $28.03 - $54.95 per hour. 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.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 #GREEN