Job Details

At UnitedHealthcare, were 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 to start Caring. Connecting. Growing together.Collaborates with UM management, Clinical Operations, and cross-functional teams. Represents UM administrative staff, ensuring timely and accurate completion of tasks within UM processes. Delivers program-specific systems training using foundational training principles and a deep understanding of UM workflows and Essette functionality for UM administrative tasks.Analyzes and improves business processes and productivity across the UM department. Handles escalated calls and resolves complex prior authorization issues. Ensures effective communication and integration of process changes, and supports clear definition, implementation, and monitoring of UM procedures. Oversees scheduling and tracking of process updates and team performance.Youll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Youll 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.

Primary Responsibilities

• Works collaboratively with UM management, Clinical Operations, and other departments using the Essette system in accordance with the Mission and Values of the company to perform the assigned duties
• Represent the UM administrative staff and be accountable for completion of assignments in the UM processes as outlined. Provide program specific systems training for staff on updates in UM processes and new business requirements, using basic training principles tools and appropriate settings, in depth understanding of the UM processes, and experience with the software. Evolve and distribute training aids for staff and maintain training and documentation process manuals
• Responsible for analyzing and improving business processes and productivity within the UM Department
• Handle escalated calls and resolve complex prior authorization issues for UM staff
• Ensure issues or changes are communicated and integrated as appropriate
• Ensure clear process definition, design, communication, implementation, monitoring and support is available to UM administrative staff. Work with stakeholders to establish areas for integration
• Schedule, track and provide oversight for any and all process updates and team productivity
• Maintain working knowledge of all UM systems. Be a Subject Matter Expert in all areas of UM system to continually evaluate workflow and process to facilitate the most efficient and streamlined processes
• Utilize individual thought and department expertise to organize and validate data to manage the development of reports, e.g., production reports, regulatory reports, utilization reports, compliance reports for internal and external audits, and validation of reports
• Respect confidentiality and maintain confidence as described in the UHG Employee Handbook and acknowledged through signature by all employees. The ability to maintain confidentiality is a critical and essential component of this position
• Assess, monitor, and improve work processes and work with UM administrative staff and leadership to implement changes. Ensures changes are communicated and integrated within the department and for external partners (i.e., providers and members)
• Manage the monitoring and updating of all correspondence. Implements structures to ensure required review is current and accessible to the team for reference
• Collaborates with Management to develop and run program reports. Assists with data definitions and works closely with Data Analyst teams to ensure accurate reporting. Scrub report files for accuracy. Point of contact for navigation of the UM modules for audits
• This position may require travel. Requires independent, reliable, flexible, and on-demand, transportation at the incumbents expense for travel between various locations and timely arrival and departure from various locations. If the employee chooses to satisfy this requirement by driving a vehicle, the employee must meet the requirements for Colorado licensure and company requirements for liability insurance coverage
• Complete all duties in accordance with company safety policies and practices
• Other functions may be assigned and management retains the right to add or change the duties at any time

Required Qualifications

• Microsoft systems knowledge
• Proven analytical and problem-solving skills, effective communication skills with technical staff and end users
• Demonstrated ability to read, analyze, interpret technical procedures, and to identify and manage routine problems
• Demonstrated ability to make decisions, multi-task, and to learn new technologies

Preferred Qualifications

• Healthcare Industry experience
• Demonstrated ability to determine how a system should work and how changes in conditions, operations, and the environment will affect outcomes
• Demonstrated ability to use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems
• Demonstrated ability to identify measures or indicators of system performance and the actions needed to improve or correct performance, relative to the goals of the system
• Demonstrated ability to identify complex problems and reviewing related information to develop and evaluate options and implement solutions
• Demonstrated ability to determine causes of operating errors and deciding what to do about it
• Demonstrated ability to conduct tests and inspections of products, services, or processes to evaluate quality or performance

*All employees working remotely will be required to adhere to UnitedHealth Groups Telecommuter PolicyPay 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, youll 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.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.