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Medical Claims Manager - National Remote

Company: UnitedHealth Group
Location: Las Vegas
Posted on: September 12, 2023

Job Description:

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.SM
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 7am - 5pm CST. It may be necessary, given the business need, to work occasional overtime. -
We offer weeks of paid on the job shadow training. The hours during training will be 8am to 5pm, Monday - Friday in your time zone. -Duration for training is based on the individual candidate and their needs. More details on the training will be discussed further during the interview process by the hiring manager. -Training will be conducted virtually from your home.
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Primary Responsibilities:
The following duties cover what are generally believed to be principal and essential functions of the job. Specific circumstances may allow or require some people assigned to the job to perform a somewhat different combination of duties.

  • Lead and manage a team of inventory specialists
  • Provide expertise claims support for all related aspects of claim system processes and claim business processing rules
  • Ensure data integrity, data security and process optimization by identifying trends and provide reports as necessary
  • Facilitate innovation of new and efficient processes
  • Use pertinent data and facts to identify and solve a range of problems within area of expertise
  • Support the team by working with business leaders to resolve problems, understand claim operational needs, define and develop team procedures
  • Responsible for the related aspects of monitoring, managing and reporting the UMR claim and call inventories

    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 higher) in Business Administration, Information Systems, or Healthcare
    • 5+ years of experience in healthcare
    • 3+ years of experience leading Projects/IMS/Reporting
    • 3+ years of experience with managing direct and indirect reports
    • 3+ years of current or previous medical claims processing experience
    • 2+ years advanced SQL coding experience
    • Advanced proficiency with Microsoft Office tools to drive analytical and data analysis
    • Experience with Microsoft Excel (creating, editing, sorting, filtering spreadsheets)
    • Ability to work a flexible 8-hour shift between 7:00am - 5:00pm CST, occasional time may be required outside the flexible shift hours

      Preferred Qualifications:

      • Master's Degree (or higher)
      • Experience with Microsoft Excel (performing VBA coding, creating pivot tables)
      • Advanced Microsoft Access skills

        Soft Skills:

        • Ability to manage multiple projects and multiple vendors
        • Ability to go above and beyond - jump in anywhere and whenever needed
        • Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product
        • Effective communicator and problem solver across multiple teams and management levels

          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

            California, Colorado, Connecticut, Nevada, New Jersey, New York, Washington or Rhode Island Residents Only: The salary range for California / Colorado / Connecticut / Nevada / New Jersey / New York / Washington / Rhode Island residents is $67,800 - $133,100.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

Keywords: UnitedHealth Group, Las Vegas , Medical Claims Manager - National Remote, Executive , Las Vegas, Nevada

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