Job Details
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.
A day in the life of this position will be supporting our existing business analyst staff who currently support external audits for our client. You will be engaged in performing admin support, gathering claim samples, providing job aid support, creating documentation, researching contracts, letters or pulling self-service reports for existing business analyst team.
Positions in this function are responsible for end-to-end business process activities - creating, controlling and improving business processes. Leads process design and project implementation teams in process improvement activities. Diagnose process improvement opportunities and develop solutions using principles of process excellence and related tools. This position is also responsible for quality reporting, analysis and audits and for developing plans and programs to support continuous quality improvement using applicable tools. May assist in the creation, implementation, and evaluation of Total Quality Management (TQM) programs. May direct design, facilitation, training and evaluation of TQM incentive programs and may oversee quality improvement projects and teams. Positions that require certification in project management or accredited Six Sigma training should use the Project Management job family. *Employees in jobs labeled with 'SCA' must support a government Service Contract Act (SCA) agreement.
This position is full time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm (local time zone). It may be necessary, given the business need, to work occasional overtime or weekends.
We offer weeks of on-the-job training. The hours of the training will be aligned with your schedule and have some platform specific training, about 90 days ramp up.
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
Primary Responsibilities:
- Handle Field and assess complaints and/or requests to troubleshoot and correct problems (e.g., work helpdesk; access relevant systems)
- Gather and/or document information on stakeholders' business requirements, specifications, and/or needs (e.g., conduct intake process; ask questions; review project charter; monitor regulation; review reports)
- Analyze business process information (e.g., metrics; analytics) to identify key issues, trends, and potential root causes (e.g., training issues; lack of understanding by user community) that point to improvement opportunities
- Work with relevant stakeholders (e.g., end users; SMEs; sponsors) to establish appropriate criteria and goals (e.g., efficiency; effectiveness) in order to direct investigation into problems and potential solutions
- Ensure obtained data and information are accurate and relevant to meet end users' needs
- Identify risks and opportunities associated with current processes
- Synthesize relevant information (e.g., IT; analytics; business operations) to develop appropriate criteria and goals (e.g., efficiency; effectiveness) for proposed solutions
- Translate technical and/or regulatory needs (e.g., analytics; IT) into business operations processes
- Document actionable solutions using appropriate artifacts (e.g., PowerPoint deck; written document) in order to describe existing opportunities and proposed solutions
- Estimate and/or quantify potential benefits, costs, and resource requirements associated with recommended business process solutions
- Propose recommended solutions following internal processes and methodologies (e.g., Requirements and Solutions Analysis)
- Summarize and communicate proposed solutions with the appropriate audiences in a manner tailored to their understanding, level, or experience
- Adapt proposed solution to new and/or unanticipated requirements and/or information
- Communicate potential impacts and risks associated with implementing proposed solutions to business partners and relevant stakeholders
- Collaborate with stakeholders (e.g., senior leadership; end users) to gain support and buy-in for proposed business process solutions
- Obtain agreements, approvals, and sign-offs in order to facilitate solution implementation
- Provide operational instruction and guidance to business partners impacted by business process solutions (e.g., procedure; system; applications)
- Develop and/or provide education to business partners in order to facilitate effective solution implementation
- Develop project plans (e.g., communication plans; implementation steps) to support solution implementation using relevant tools and databases (e.g., MS Project; SharePoint; MS Word; AS400 Mainframe)
- Obtain needed resources (e.g., different functional teams; subject matter experts; internal and/or external stakeholders) to implement business solutions
- Conduct and/or support relevant testing (e.g., pre-production; user acceptance; post-production) to validate processes are working as designed
- Communicate any identified defects with relevant stakeholders (e.g., project managers; business partners; IT) and/or facilitate appropriate adjustments
- Provide input into and/or develop relevant policies, procedures, and/or work tools to support new or updated business processes
- Report to relevant stakeholders (e.g., business sponsors; constituents) on benefits, challenges, and progress of solution implementation (e.g., risks and opportunities)
- Create and/or oversee processes to gather stakeholder feedback on solution effectiveness
- Monitor on-going progress of business processes (e.g., collect and review data; shadow end users; review pertinent metrics) to identify potential challenges, risks, and/or defects
- Assess and/or document the outcomes (e.g., risks; benefits; impacts) of business decisions and/or changes (e.g., new client implementations; new health-care regulations) on implemented business processes
- Communicate with stakeholders (e.g., senior leadership; end users) to keep them informed of key performance indicators and/or risks through informal and/or formal reporting
- Collaborate with stakeholders (e.g., senior leadership; end users) to ensure consistent use and application of solutions across functions and teams
- Utilize stakeholder (e.g., senior leadership; end user) feedback and/or process performance information to identify potential continuous improvement opportunities
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
- Understanding of basic process management and total quality management principles and methodologies (e.g., Six Sigma; Lean)
- Understanding of basics of transaction monitoring (e.g., claims processing; eligibility transactions; customer installation)
- Understanding of relevant organizations' operations, products and applications, strategies, processes, and/or business priorities in order to build effective solutions
- Develop, demonstrate, and continuously improve understanding of upstream and downstream impacts to partners of business process operations and solutions
- Basic knowledge of Microsoft Office Word (ability to open and navigate a word document) and Microsoft Excel (ability to open and navigate a spreadsheet)
- Ability to work an 8-hour shift between 8:00am – 5:00pm, Monday - Friday including the flexibility to work occasional overtime or weekends per business need
Preferred Qualifications:
- Claim auditing experience for Physician and Facility claims on any of Optum Health's current claim systems (OBH Facets, CSP Facets, COSMOS, UNET, CMC Facets, SAM)
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
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington, Rhode Island, OR Washington, D.C. Residents Only: The hourly range for this is $19.47 - $38.08 per hour. 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.
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UnitedHealth Group is a health care and well-being company that’s dedicated to improving the health outcomes of millions worldwide. We are... Read more