You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.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.This is an opportunity that’s all about where you’ve been. Your experience. Your potential. Your skills. Because on the team at UnitedHealth Group , your potential and your impact can be career changing. No company has put together better teams of passionate, energetic and all out brilliant Claims Supervisor . This is where you come in. We’ll look for your experience and expertise to help keep our service levels and accuracy extremely high. We’ll also look for your ideas on how to constantly evolve our claims processes.This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am – 4:30pm CST. It may be necessary, given the business need, to work occasional overtime or weekends.We offer weeks 3 weeks of on the job paid training. The hours during training will be 8:00am to 4:30 pm CST, Monday - Friday. Training will be conducted virtually from your home.All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.Primary Responsibilities:
Oversee Election submission staff and Quality Analysts.
Analyze and identify trends and provides reports, as necessary.
Review workflow and triage processes.
Determine schedule and staffing needs.
Understand CMS regulations and guidance.
Assist on projects as assigned by management.
Develops Plans to meet short objectives.
Sets priorities for the team to ensure task completion.
This is a challenging role that takes an ability to thoroughly review, analyze and research complex health care claims in order to identify discrepancies, verify pricing, confirm prior authorizations and process them for payment. You’ll need to be comfortable navigating across various computer systems to locate critical information. Attention to detail is critical to ensure accuracy which will ensure timely processing of the member's claim.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 higher) OR equivalent years of work experience
18 years of age or older
1+ years of leadership and or subject matter expert
3+ years of PBM or Healthplan experience
Experience proficiency using Microsoft Word (create and / OR edit docs, sending correspondence), Microsoft Excel (updating reports, spreadsheets, ability to create and / OR edit, basic formulas, sorting, filtering), Microsoft PowerPoint (create and / OR edit presentations), Microsoft Outlook (email, scheduling meetings)
Flexible to work an 8-hour shift between the hours 8:00am – 4:30 pm that can in include weekends and holidays based on business needs.
Preferred:
Managing daily task of others (training, coaching, mentoring)
Retail pharmacy experience.
RxClaim System
Telecommuting Requirements:
Ability to keep all company sensitive documents secure (if applicable)
Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
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:
Excellent customer service
Ability to influence and negotiate through use of verbal, written, and interpersonal means with a diverse group of people/disciplines at all levels of an organization.
Problem solving, propose, and implement solutions.
Time management skills and ability to multi-task and prioritize work.
Written and verbal communication skills
Ability to work in a complex fast-paced environment, flexible and adaptable to changing situations, and a strong commitment to teamwork.
Ability to remain calm in stressful situations and to always display professional conduct.
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington or Rhode Island Residents Only : The salary range for this is $48,300 - $94,500 per year. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.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