You have your own reasons for wanting to work here. But here are a few incentives we think are pretty compelling.

Apr 18, 2018
In this exciting role, you will be accountable for supporting and designing the user experience of web applications as part of the Be Fast and Flexible (BFF) initiative that seeks to modernize and transform the Insurance Solutions’ Claim Processing and Policy Administration systems. The Junior User Experience Designer is responsible for working with stakeholders to ascertain functional requirements, build interactive wireframes and prototypes, and work with the broader user experience and delivery teams to establish application-level UX / UI standards. The ideal candidate will be dedicated to excellence with a profound ability to find solutions to problems in a complex and constantly changing environment. Candidates must have experience with interactive wireframing / prototyping and should be comfortable working with stakeholders and presenting recommendations.Primary Responsibilities:Ensure that a modernized, user-centric experience is designed and implemented that meets the comprehensive requirements of the organization Design wireframes and / or prototypes to visually demonstrate functionality and interactivity of web-based software applicationsWork with stakeholders to craft and implement solutions that achieve business goals and are effective for end usersCreate functional specifications and other UX / UI documentation intended for developers and product owners Identify opportunities for improvement with existing work and processesProvide limited support for the visual (UI) design (as a backup / emergency resource - but the opportunity exists for more if desired) Required Qualifications:Bachelor's Degree (or higher) in Creative or Technology related fields or High School Diploma / GED with 4+ years of UX work experience2+ years of work experience relevant to User Experience (UX)Experience with software used to create wireframes and prototypesExperience performing research and making recommendations based on real data and past experienceMust be able to provide a portfolio or sample of previous workAbility for up to 5% overnight travel within the USPreferred Qualifications:Axure RP experience is a strong plusExperience with Sketch and PhotoshopExperience designing for web applicationsExperience working in an Agile project management processPrevious work experience within health care and / or health insuranceSoft Skills:Scans the horizon for emerging tools, skills, and techniques to ensure timely introduction of best practicesCombine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.SMCareers at UnitedHealthcare Medicare & Retirement. The Boomer generation is the fastest growing market segment in health care. And we are the largest business in the nation dedicated to serving their unique health and well-being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our health care system. Ready? It's time to do your life's best work.SMDiversity 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.Keywords: UnitedHealth Group; User Experience Designer; Wauwatosa, WI; Horsham, PA; UX; wireframes; prototypes; Axure RP; Sketch; Photoshop; web applications; Agile; health care b998648f-e8a8-4cce-8b2a-15530286a1d1 *Junior User Experience Designer - Wauwatosa, WI; Horsham, PA* *Wisconsin-Wauwatosa* *762615*
UnitedHealth Group Wauwatosa, WI, USA
Apr 18, 2018
Great sales are the result of strong purpose, conviction and pride - pride in your ability and your product. UnitedHealth Group offers a portfolio of products that are greatly improving the life of others. Bring along your passion and do your life's best work.Provides administrative and clerical support by preparing statistical reports, organizing and maintaining paper and electronic files, maintaining unit databases and working with carriers / brokers as needed.Primary Responsibilities: Maintain and update Stop Loss Tracking database and other databases as needed Review proposals from carriers and enter in Proposal system Review Stop Loss policies from carriers and ensure compliance with internal databases Send Stop Loss policies to SAE and document appropriately Send Plan Document to Stop Loss Carrier to ensure timely issuance of Stop Loss policy Initiate follow-up phone calls to carriers for quotes and renewal status as well as claimant information File and maintain records and data Produce information by formatting, faxing, inputting, editing, retrieving, copying, and transmitting data Contributes to a team effort by accomplishing related results as needed Required Qualifications: High School Diploma / GED (or higher) Data Entry experience Experience with Microsoft Office including Word (create documents), Excel (create spreadsheets), PowerPoint (create presentations), and online formats such as Internet ExplorerPreferred Qualifications: Stop loss knowledge Experience in the Healthcare industryCareers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.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. Keywords: Stop Loss, Business Operations, Sales, Sales Support, Sales Operations, Stop Loss Technician, UHC, Insurance, Medical Insurance 2e05aa9a-a9ad-4ad6-854a-bf27d46e861b *Sales Operations Representative - Wausau,WI, Onalaska, WI, Cincinnati, OH, or San Antonio, TX* *Wisconsin-Wausau* *760312*
UnitedHealth Group Onalaska, WI 54650, USA
Apr 18, 2018
Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work. The Claims Clerk is responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims. Primary Responsibilities: Provide general claims support by reviewing, researching, investigating, negotiating, processing and adjusting claims Authorize the appropriate payment or refers claims to investigators for further review Conduct data entry and re - work; analyzes and identifies trends and provides reports as necessary Analyze and identify trends and provide reports as necessary Consistently meet established productivity, schedule adherence, and quality standards Recognize claims by determining claim type - HCFA, Hospital, UB, and / or RX Identify more complicated claims and refer them to Senior Claim Processor or Supervisor Calculate other insurance and re - pricing benefits Work claims files to ensure the appropriate eligibility and provider records are matched to the claim Updates and maintains claims tracking database Limited work experience Works on simple tasks using established procedures Depends on others for guidance Work is typically reviewed by others Required Qualifications: High School Diploma / GED (or higher) 1+ years of experience in an office setting environment using a computer as the primary instrument to perform job duties 1+ years of experience managing with multiple tabs within Internet Explorer in a work environment Ability to work Monday through Friday from 8:00 am - 4:30 pm for training and 7:00 am - 5:00 pm (8 hours) after trainingPreferred Qualifications: Prior experience working with Medical Claims Ability to type 60+ WPM Proficient with 10 key numeric pad data entry Experience in production based environment Understanding of Healthcare Claims including ICD-10 and CPT codesPhysical Requirements and Work Environment: Extended periods of sitting at a computer and use of hands / fingers across keyboard or mouseCareers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of healthcare. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life’s best work. 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.Keywords: customer service representative, customer service, CSR, UnitedHealth Group, call center, UnitedHealthcare, health care, office, phone support, claims clerks, Wausau,WI , medical claims , healthcare claims ed593af3-50c6-4db4-a996-9d9e3db62606 *Claims Clerk - Wausau, WI* *Wisconsin-Wausau* *762333*
UnitedHealth Group Wausau, WI, USA
Apr 18, 2018
Great sales are the result of strong purpose, conviction and pride - pride in your ability and your product. UnitedHealth Group offers a portfolio of products that are greatly improving the life of others. Bring along your passion and do your life's best work.Provides administrative and clerical support by preparing statistical reports, organizing and maintaining paper and electronic files, maintaining unit databases and working with carriers / brokers as needed.Primary Responsibilities: Maintain and update Stop Loss Tracking database and other databases as needed Review proposals from carriers and enter in Proposal system Review Stop Loss policies from carriers and ensure compliance with internal databases Send Stop Loss policies to SAE and document appropriately Send Plan Document to Stop Loss Carrier to ensure timely issuance of Stop Loss policy Initiate follow-up phone calls to carriers for quotes and renewal status as well as claimant information File and maintain records and data Produce information by formatting, faxing, inputting, editing, retrieving, copying, and transmitting data Contributes to a team effort by accomplishing related results as needed Required Qualifications: High School Diploma / GED (or higher) Data Entry experience Experience with Microsoft Office including Word (create documents), Excel (create spreadsheets), PowerPoint (create presentations), and online formats such as Internet ExplorerPreferred Qualifications: Stop loss knowledge Experience in the Healthcare industryCareers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.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. Keywords: Stop Loss, Business Operations, Sales, Sales Support, Sales Operations, Stop Loss Technician, UHC, Insurance, Medical Insurance 2e05aa9a-a9ad-4ad6-854a-bf27d46e861b *Sales Operations Representative - Wausau,WI, Onalaska, WI, Cincinnati, OH, or San Antonio, TX* *Wisconsin-Wausau* *760312*
UnitedHealth Group Wausau, WI, USA
Apr 18, 2018
This position is responsible for establishing the appropriate procedures and controls around existing and new interfaces to ensure programs are operating within parameters ultimately enhancing NPS results, while meeting the needs of UMR’s growing client base. Responsible and a resource for monitoring and managing internal and external processes including performance of the product and devising remediation plan when necessary. This position is a key resource for quality and process management which includes analyzing operational data to compare outcomes to program criteria evaluating services provided. Serve as a resource and lead care management quality improvement program. Conducts quality audits, documentation, standards of operation, and provides feedback and/or develops actions plans to reduce errors and improve processes and performance. Jointly responsible for helping ensure products meet applicable compliance requirements. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Development of continuous quality improvement processes Review and identify opportunities to enhance care management reporting Communicate determinations and impact business outcomes Manage company and clinical initiatives to mitigate for risk Create and conduct client audit processes against standard and non-standard requirements to ensure compliance minimizing risk. Work cross-functionally to develop interventions or recommendations Identify/anticipate future business needs based on changes in the internal and external environment providing recommendations and develop plans to meet those needs Interact with senior management, account and sales teams, and business development criteria and develop solutions to effectively meet their needs for quality improvement and reporting Present information to sales and account teams and effectively translate solutions and answers for coordination with business development, sales and account management Maintains working relationships with cross-functional work areas to effectively support and develop solutions to meet customer needs Coordinates activities with all parts of the organization and monitors organizational change Drive excellence with internal partners and external vendors through reporting and analytics Present analysis and interpretation for operational and business review and planning Other duties as assigned Competencies, Knowledge, Skills, and Abilities: Demonstrates an ability to develop creative solutions and problem solving Proactive- does not wait for things to happen Drives and manages change to appropriate implementation and conclusion Evidence of ability and willingness to learn and adapt to frequent changes to work flows, processes and procedures resulting from new technology, customer demands, competitive pressures, etc. Proven ability to adapt quickly to unique situations and make decisions Demonstrates initiative and proactivity in dealing with issues and driving them to conclusion Excellent communication skills, both oral and written, demonstrated by an ability to coordinate and communicate across functional departments, and with external contacts High degree of analytical skills demonstrated through extensive experience analyzing data, identifying problems, and recommending solutions Evidence of sound analytical, problem solving and decision making skills for resolving customer, provider and producer concerns, processing, and workflow issues Evidence of ability to work independently and to plan, organize, and accomplish assignments in a timely and credible manner Required Qualifications: Bachelor’s degree in business, healthcare management or related field 4 years or more of experience developing and supporting quality and process improvement programs 4 years or more of experience data analysis background and report interpretation capabilities including measurements of program outcomes 4 years or more experience in healthcare 4 years or more experience in project management Experience performing quality audits, documentation, standards of operation, and develops actions plans to reduce errors Intermediate to advanced proficiency with MS Office applications Demonstrated ability to work collaboratively and influence others Effectively communicate at all levels of the organizations Demonstrated excellent verbal and written communication skills Preferred Qualifications: Advanced Degree Bring your incredible ideas to an incredible company where you'll have a singular opportunity to do your life's best work.(sm) *All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy 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. 80485d81-0571-4b6d-9889-daf8abe3fd74 *Product Consultant - Multiple Locations or Telecommute* *Minnesota-Minnetonka* *760504*
UnitedHealth Group Wausau, WI, USA
Apr 18, 2018
At Optum, the mission is clear: Help people live heathier lives and help make the health system work better for everyone LHI is one of 4 businesses under OptumServe. OptumServe provides health care services and proven expertise to help federal government agencies modernize the U.S. health system and improve the health and well-being of Americans.By joining OptumServe you are part of the family of companies that make UnitedHealth Group a leader across most major segments in the U.S. health care system. LHI was founded in 1999 and acquired by Optum in 2011, LHI specializes in creating and managing health care programs through on-location services, patient-specific in-clinic appointments, telehealth assessments, or any combination based on customer need. LHI's customizable solutions serve the diverse needs of commercial customers, as well as federal and state agencies, including the U.S. Departments of Defense, Veterans Affairs, and Health and Human Services. There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Ready for a new path? Start doing your life's best work.(sm) We are currently seeking an RN, Clinical Review based in Eau Claire, WI. This individual will be responsible for evaluating and providing a clear, comprehensive and concise review of VA Disability Exams. In addition, they will evaluate and determine if medical documentation meets contractual requirements for compensation and benefit rating purposes. Primary Responsibilities: Evaluate and process medical information to determine outcomes for disability exams Ensure documentation on Disability Benefits Questionnaires meet customer requirements Create clear, comprehensive, and concise retrieval letters to external practitioners as needed Complete department tasks to process medical documentation Prepare documents for internal medical team review Remain up to date with contract requirements Please Note: In order to be considered for this position, you must be able to obtain an SF86 Position of Trust which is only available to U.S. Citizens. Our Facilities Security Officer will initiate this process post-offer acceptance. Failure to obtain this will result in termination from this role. Required Qualifications: Graduate of an accredited Associate’s Degree in Nursing (ADN) or Bachelor’s Degree in Nursing (BSN) program Current license or able to obtain RN licensure in the state of Wisconsin or a compact state Proficient computer skills in Microsoft Office and database experience Must possess excellent verbal and written communication skills Effective interpersonal, communication and problem solving skills Knowledge of standard concepts, practices, and procedures within the field Analytical thinking and team work skills Ability to perform detailed work with a high degree of accuracy United States Citizenship Ability to obtain favorable adjudication following submission of Defense Health Agency eQuip Form SF86 Preferred Qualifications: 1 year clinical experience, preferably in a medical/surgical environment VA and/or military experience a plus Familiarity with government forms and documentation Understanding of regulatory standards and their application to various medical examinations and documents National Career Readiness Certificate UnitedHealth Group is working to create the health care system of tomorrow. Already Fortune 6, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good. Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed. Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams. 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. Keywords: Registered Nurse, RN, Clinical, Military, Veteran, Medical, Wisconsin 128bfc77-47ca-4542-8d2a-edb91aaceef6 *Clinical Review RN - LHI - Eau Claire, WI* *Wisconsin-Eau Claire* *755939*
UnitedHealth Group Eau Claire, WI, USA
Apr 18, 2018
Help write the history of UnitedHealth Group as a part of Government Relations while healing the health care system and improving the lives of others. Bring along your passion and do your life's best work.(sm) The Director of Engagement & Advocacy would be primarily responsible for helping the growth team develop and implement actionable strategies to engage community members and CBOs in key growth and expansion states. The Director would work with the BD team and other members of the growth team to identify gaps in community-focused relationships and those organizations that advocate on their behalf. The purpose being to identify the influencers, develop outreach and engagement plans with the goal of creating on the ground coalitions and partnerships that will advance our reputation within and enhance our learnings from the communities we seek to serve. This individual would come to the position with substantive experience in working with diverse low-income communities and developing targeted community coalitions/partnerships with the aim of improving population specific health challenges within those respective communities. This individual would have experience taking policy positions/analysis and translating it to the “what is the impact on the Medicaid beneficiary” level and articulating how we can collectively work together with that aim in mind. This individual would be strategic and know how to coordinate with policy and thought-leadership in a manner that furthers our reputation and aims to move the system in question to the next level of transformation. This position will support existing markets with advocacy recommendations during re-procurement and on an ongoing basis as identified by the Market Health Plan CEO or SVP, Policy and Strategy. The Director will also be responsible for developing educational materials for internal constituents to help them become proficient on the needs of the population, positions taken by stakeholders, and market-specific advocacy efforts to ensure that the organization is optimally positioned with stakeholders. In total, C&S employs over four-thousand employees and serves more than six-million members in 24 states and the District of Columbia. C&S is the largest health benefits company dedicated to the economically disadvantaged, medically underserved and those without employer-funded health care coverage. This position will report to the VP, Community & Strategic Development within the UnitedHealthcare Community and State organization. Primary Responsibilities: Contribute to and Execute on Market Entry Plans Assist VP, Community & Strategic Development in developing annual and market-specific advocacy plans to support growth and business objectives Work collaboratively with the Business Development team to support and conduct market assessment and engagement opportunities Develop and implement targeted advocacy frameworks for specific market opportunities Elevate awareness and ensure perspectives and concerns raised by external organizations are appropriately reflected in the market entry plans Cultivate and maintain strategic relationships as directed by the national advocacy plan with organizations to support growth and business objectives Developing model partnerships with key constituencies that could be replicated or leveraged in multiple states. Dissemination of Knowledge Develop internal materials with culturally-appropriate information about the identified population and related messaging from advocates and stakeholders Support and inform market engagement strategies to ensure positive growth position Serve as an SME for new health plans and functional leaders to develop capacity and competencies about opportunities to advance collaborations or partnerships in the market Serving as an SME at external conferences to raise the profile of UHC and its efforts to advance improvements or partnerships in diverse communities. Support National Initiatives Support the Product and Clinical teams by providing ongoing insights into the needs of the populations, messaging of stakeholders, and changing environment Work collaboratively with the Operations, Finance, Sourcing and Procurement, and Business Development teams on RFP opportunities to help assess and identify ways to differentiate UHC in the market. Required Qualifications: Bachelor’s Degree in Public Policy, Law, Public Health or a related field 5+ years of lobbying or advocacy experience at the national or state level Experience working with low-income, diverse communities Experience creating or conducting trainings or educational sessions Strong written and verbal communication skills Strong interpersonal skills around building strategic relationships with individuals across the political and advocacy spectrum Bilingual or bi-literate Spanish/English, preferred but not required Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm) 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. ca0283f4-db17-4c9c-ae78-de19a549682f *Director, Engagement and Advocacy - Multiple Locations* *California-Los Angeles* *759882*
UnitedHealth Group Seattle, WA, USA
Apr 18, 2018
You get it. Everyone gets it. The health care system needs to evolve even further than it has and it has to do so quickly. New models of care and new networks of providers are emerging now to better serve patients and communities. And leaders like UnitedHealth Group are playing a lead role. Here’s where you come in. As member of our network contracting team, you’ll help develop and support Provider Networks and guide unit cost management activities through financial and network pricing modeling, analysis and reporting. As you do, you’ll discover the impact you want and the resources, backing and opportunities that you’d expect from a Fortune 6 leader. Primary Responsibilities: Manage unit cost budgets, target setting, performance reporting and associated financial models Predict emerging customer needs and develop innovative solutions to meet them• Help develop geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management Evaluate and negotiate physician and hospital contracts in compliance with company templates, reimbursement structure standards, and other key process controls Ensure that network composition includes an appropriate distribution of provider specialties If you are located in Idaho or near states, you will have the flexibility to telecommute* as you take on some tough challenges. Get ready for a high impact role. You’ll be tasked with working in conjunction with our national clinics and hospitals to manage, collect and analyze provider data, updating and loading provider data and resolving any escalated issues with the clients. Required Qualifications: 3+ years of experience in a network management-related role, such as contracting or provider services In-depth knowledge of Medicare Resource Based Relative Value System (RBRVS) In-depth knowledge of physician fee schedule methodologies 1+ years of experience using financial models and analysis to negotiate rates with providers Intermediate level of knowledge of claims processing systems and guidelines Preferred Qualifications: Undergraduate degree 1+ years of experience in performing network adequacy analysis Currently reside in the state Idaho Creating and fine tuning provider networks helps improve access to health care for millions. It’s an outstanding opportunity to have more meaning and purpose in your career. Join us. Find out how you can start doing your life’s best work.SM Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.SM* *All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy. 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. Job Keywords: Managed Care, Provider Contracting, Physician Contracting, Facility Contracting, Hospital Contracting, Healthcare, Boise, ID, Idaho, Seattle, WA, Washington,Phoenix, AZ, Arizona, Las Vegas, NV, Nevada, Denver, CO, Colorado 0c3a4f63-30b5-4862-8c5e-21431be7eec8 *Network Contract Manager - Boise, ID* *Idaho-Meridian* *759414*
UnitedHealth Group Seattle, WA, USA
Apr 18, 2018
Serving millions of Medicare and Medicaid patients, Optum is the nation’s largest health and wellness business and a vibrant, growing member of the UnitedHealth Group family of businesses. We’re also the career home for Nurse Practitioners who are eager to bring compassion and passion, energy and focus to their work every day. Join us and you’ll discover a chance to build meaningful relationships with the patients, their families and the health care providers who are responsible for their care. Primary Responsibilities: Conduct in-home assessments on health plan members, including past medical history, review of symptoms, physical examination, medication review and depression screening Responsible for checking vitals, conducting a physical exam that includes monofilament test, urine dipstick and foot exam (as appropriate) Identify diagnoses to be used in care management and active medical management in the furtherance of treatment Formulate a list of current and past medical conditions using clinical knowledge and judgment and the findings of your assessment Communicate findings in your assessment that will be used to inform the PCP of potential gaps in care Educate members on topics such as disease process, medication and compliance Comply with all HIPAA regulations and maintain security of protected health information(PHI) Since this position involves in-home visits, the ability to work autonomously and extensive travel will be required. You should also be comfortable working with geriatric patients who have a variety of health complications. Required Qualifications: Active, unencumbered license to practice nursing in the assigned state Nurse Practitioner Certification from either the ANCC, AANP or AACN as Adult, Geriatric, Family or Acute Care NP 1+ year of clinical experience in highest level of education OR 3+ years of experience as a Registered Nurse Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area Ability to obtain DEA licensure/prescriptive authority post-hire in states where applicable Ability to spend at least 1 hour with a member in their home, which may be in understaffed or remote areas, in the presence of pets or individuals who are tobacco users Ability to lift a 30 pound bag in and out of car and to navigate stairs and a variety of dwelling conditions and configurations Preferred Qualifications: Experience in Gerontology, Cardiology, Internal Medicine or Endocrinology Home care or home visit experience Excellent administrative and organizational skills and the ability to effectively communicate with seniors and their families Computer literate and able to navigate the internet Transforming health care and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm) **PLEASE NOTE** The sign on bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time, or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus. 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. Job Keywords: Nurse Practitioner, NP, long term care, LTC, Assisted Living, Nursing Home, Primary Care, Assessment, Home Care, House Calls, Independence, MO, Missouri, Jackson County 6e4f4368-b464-433c-a822-99694c68c72c *Nurse Practitioner, House Calls - Per Assessment - $2,500K SIGN ON For External Candidates - Grayson County - TX* *Texas-Sherman* *755681*
UnitedHealth Group Sherman, TX, USA
Apr 18, 2018
Here, you'll help attract, lead, support and reward our most valuable asset: our high caliber people. Here, you're expected and empowered to be your best, to grow and to develop your skills. Be prepared to move quickly, to engage proactively, and to think strategically. Join us and help people live healthier lives while doing your life's best work.(sm)Contributes to business performance by providing strategic consulting on people strategies, organization development and other Human Resources specific or business initiatives for a defined business or operational area. Primary Responsibilities: Strategic and Organization Consulting: Consults on people matters relating to the formulation of the operational area's Human Capital strategy and plan along with the organizational requirements to execute that strategy and plan Workforce Planning: Conducts in-depth supply and demand analyses of the current and future people and skills needs of the organization and develop strategies and plans to meet those needs. Aids in defining talent management, recruiting strategy and execution, and talent retention plans and MBOs. Provides managers with human capital management information from the HR/PeopleSoft assets, Talent Surveys, and Recruiting profiles, and assists them with using this information Culture, Vision and Values: Facilitates the definition and communication of the organization culture, visions and values which to guides the decisions and actions of the managers and employees of the organization. Acts as a change agent to the business and designs processes and approaches, which prepare employees for ongoing change and transformation Leadership and Key Talent Development, Retention and Acquisition: Creates processes and experiences that grow the capacity of the organization's key people resources which include key talent identification, planning, development and recruitment Encourages building strength through diversity. Designs and implements retention strategies focusing on key leaders and individuals with core competencies or skills critical to the organization. Maximizes the enterprise-wide compensation, reward and recognition programs and develops additional initiatives which will support the goals of the business segment Employee Involvement and Engagement: Identifies through elements of the work environment strategies to increase productivity, employee performance, and employee satisfaction and design metrics to track the effectiveness of these initiatives Creates processes and solutions in partnership with management which support a positive employee relations environment through effective communications, policies and practices Organizational Change and Integration: Assists in the human capital strategies to ensure effective integration of acquisitions. This may include cultural assimilation and talent identification and selection. Provides guidance and counsel on the people decisions and actions, which are involved in divestiture activity. Primarily interacts with business leaders in the defined business or operational area as well as the larger enterprise. Extensive interaction and effective working relationships with the Human Resources Service Environment staff to ensure effective development and implementation of programs, practices and processes to meet business needs Develops the strategic Human Capital Plan, which aligns with the overall segment Human Capital Plan. Provides organization consulting on key people strategies in support of the business segment objectives. Initiates key talent development, sourcing and deployment strategies, which may apply segment-wide or enterprise-wide Required Qualifications: Bachelor’s degree in Human Resources, Business or related field or demonstrated equivalency, or SPHR/PHR certification 10+ years of Human Resources generalist experience with expertise in all Human Resources functional areas with a strong emphasis in organization development/effectiveness and leadership development Experience in leadership coaching and team effectiveness 5+ years of experience supporting large >500 multi-disciplinary operations/manufacturing functions and multiple senior leaders Experience working in a Human Resources function with a shared service delivery and strategic business partner model Demonstrated history of quickly gaining credibility and partnering with business leaders Experience and agility working in a matrix environment, across multiple geographies Agile thought leadership, comfortable with ambiguity, with the ability and confidence to drive business decisions Intermediate level of proficiency with MS Office (Word, Excel and PowerPoint) Must be willing and able to work Monday through Friday at our office in San Antonio TX or Greensboro NC. This is not a telecommuter role Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.SM 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. Job Keywords: Human Capital Partner, San Antonio, TX, Texas, Greensboro, NC, North Carolina 5ff675b7-b932-44c2-8dbf-e73cba247e47 *Human Capital Partner - San Antonio TX or Greensboro NC* *Texas-San Antonio* *762777*
UnitedHealth Group San Antonio, TX, USA
Apr 18, 2018
Great sales are the result of strong purpose, conviction and pride - pride in your ability and your product. UnitedHealth Group offers a portfolio of products that are greatly improving the life of others. Bring along your passion and do your life's best work.Provides administrative and clerical support by preparing statistical reports, organizing and maintaining paper and electronic files, maintaining unit databases and working with carriers / brokers as needed.Primary Responsibilities: Maintain and update Stop Loss Tracking database and other databases as needed Review proposals from carriers and enter in Proposal system Review Stop Loss policies from carriers and ensure compliance with internal databases Send Stop Loss policies to SAE and document appropriately Send Plan Document to Stop Loss Carrier to ensure timely issuance of Stop Loss policy Initiate follow-up phone calls to carriers for quotes and renewal status as well as claimant information File and maintain records and data Produce information by formatting, faxing, inputting, editing, retrieving, copying, and transmitting data Contributes to a team effort by accomplishing related results as needed Required Qualifications: High School Diploma / GED (or higher) Data Entry experience Experience with Microsoft Office including Word (create documents), Excel (create spreadsheets), PowerPoint (create presentations), and online formats such as Internet ExplorerPreferred Qualifications: Stop loss knowledge Experience in the Healthcare industryCareers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.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. Keywords: Stop Loss, Business Operations, Sales, Sales Support, Sales Operations, Stop Loss Technician, UHC, Insurance, Medical Insurance 2e05aa9a-a9ad-4ad6-854a-bf27d46e861b *Sales Operations Representative - Wausau,WI, Onalaska, WI, Cincinnati, OH, or San Antonio, TX* *Wisconsin-Wausau* *760312*
UnitedHealth Group San Antonio, TX, USA
Apr 18, 2018
There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm) The Clinical Quality Consultant will drive consistency, efficient processes and share best practices – in a collaborative effort with the providers – designed to facilitate a minimum 4 STAR rating. The CQC will participate in quality improvement initiatives, develop recommendations for quality remediation plans and create tools and databases to capture relevant data for each region. This position will work collaboratively with each regional/market team and their leadership in a matrix relationship. Primary Responsibilities: Develop market business plans to motivate providers to engage in improving Stars measures to be 4 STARS or higher Provide analytical interpretation of Stars and HEDIS reporting, including executive summaries to plan and provider groups Be the primary go to person for all STARS related activities within their assigned market(s) working within a matrix relationship which includes Quality corporate operations and Regional/Market operations Assist in developing of training and analytical materials for Stars and HEDIS Lead or participate and present in weekly, Monthly, Bi-monthly, Quarterly and / or Annual business Review meetings related to STAR activities which summarize provider group performance and market performance as requested by or required by Quality or Regional leadership Analyze and evaluate provider group structure and characteristics, provider group/provider office operations and personnel to identify the most effective approaches and strategies Identify and assess decision makers and other key provider group personnel with a focus on identifying barriers to achieving targeted outcomes Focus communications and efforts accordingly Develop solution-based, user friendly initiatives to support practice success Required Qualifications: Registered Nurse (within the states in which service is being delivered) with undergraduate degree or (4 years equivalent experience above and beyond the required years of experience may be considered in lieu of undergraduate degree) 4+ years of associated business experience within the health care industry including experience with HEDIS / Stars Ability to travel 50 - 75% locally, with occasional overnight travel Experience influencing others resulting in changes in behavior (preferably with providers in various care delivery models) Experience in managed care working with network and provider relations Experience in provider-facing HEDIS strategy and education Experience presenting education of HEDIS / Stars material to providers and provider office staff Strong knowledge of the Medicare market, products and competitors Knowledge base of clinical standards of care, preventative health, and Star measures Financial analytical background within Medicare Advantage or government programs (Risk Adjustment / STARS Calculation models) Microsoft Office specialist with exceptional attention to detail; must be proficient with Excel This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor’s diagnosis of disease Preferred Qualifications: Undergraduate degree or post graduate degree Billing and CPT coding experience Clinical data abstraction experience Strong communication and presentation skills Strong relationship building skills with clinical and non-clinical personnel Demonstrated ability to interact with medical staff, peers, and internal company staff at all levels Ability to solve process problems crossing multiple functional areas and business units Strong problem-solving skills; the ability to analyze problems, draw relevant conclusions and devise and implement an appropriate plan of action Adaptable to change Excellent customer service skills Good business acumen, especially as it relates to Medicare Medical / clinical background Physical & Mental Requirements: Ability to lift up to 10 pounds Ability to sit for extended periods of time Ability to stand for extended periods of time Ability to use fine motor skills to operate office equipment and / or machinery Ability to properly drive and operate a vehicle Ability to receive and comprehend instructions verbally and / or in writing Ability to use logical reasoning for simple and complex problem solving Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 240,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm) 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. Job Keywords: RN, clinical, consultant, healthcare, HEIDS, Medicare, Hidalgo county, Texas, TX 82b16a62-9999-422a-8d29-6399bc1cf840 *RN - Clinical Quality Consultant - Hidalgo County, TX* *Texas-McAllen* *759300*
UnitedHealth Group McAllen, TX, USA
Apr 18, 2018
Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm) The Clinic Manager provides leadership, direction and administration of operations to ensure accomplishment of clinic and organizational objectives. Directs, supervises and coordinates the overall operation of the clinic and staff. Primary Responsibilities: Directs, supervises, coordinates specific functions and activities of clinic, including systems, policies and procedures, human resources, support services, etc. required Assists the Medical Director in the development and marketing of new services and referral sources Facilitates the employment, development and management of employees Promotes the provision of cost-effective, high-quality health care services to patients Cooperates with medical and administrative staff to ensure compliance with standards and regulations Reviews operational problems/policies and recommends solutions and change to Medical Director Collaborates with Medical Director in the preparation and implementation of quarterly budgets. Recommends funding based on knowledge of policies, costs, and operating practices Represents clinic at public and professional meetings and conferences Participates in clinic communication and public relations programs Maintains professional affiliations and enhances professional development to keep pace with the trends in health care administration Performs other related duties which may be inclusive, but not listed in position job description Required Qualifications: Bachelor degree in Healthcare Administration, Business Administration, Nursing or related field (4 additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelor’s degree) 3+ years of healthcare administration experience required, including one year of clinic supervisory experience Computer literacy Knowledge of the following: Health care administration, clinic philosophy and policies and operating procedures Fiscal management systems Human resource management practices including supervision and staff development Knowledge of governmental regulations and reimbursement standards Computer programs and applications Skill in the following: Exercising initiative, judgment, problem solving, decision making Developing and maintaining effective relationship with staff, Senior Management, patients, vendors, payers, public Organizing work to achieve clinic goals and objectives Ability to complete the following: Analyze and interpret complex data Research and prepare comprehensive reports Monitor compliance standards This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor’s diagnosis of disease Preferred Qualifications: Professional healthcare license or certification Current unrestricted Vocational Nurse license for applicable state of employment Supervisory experience within a clinic setting Physical & Mental Requirements: Ability to lift up to 100 pounds Ability to push or pull heavy objects using up to 300 pounds of force Ability to use fine motor skills to operate equipment and/or machinery Ability to receive and comprehend instructions verbally and/or in writing Ability to use logical reasoning for simple and complex problem solving Occasionally requires exposure to communicable diseases or bodily fluids Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 240,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm) 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. Job Keywords: clinic manager, supervisor, healthcare administration, Dallas, TX, Texas 60fb3064-b791-4aff-b7ca-d641d1d7202a *Clinic Administrator - WellMed at South Bucker - Dallas, TX* *Texas-Dallas* *761541*
UnitedHealth Group Dallas, TX, USA
Apr 18, 2018
OptumCare seeks to create a high value healthcare delivery system in 75 markets. This position’s primary objective will be to identify the path to build out the service line strategy for each market (current and prospective), maximize the financial journey across the risk continuum by market, and develop a clear and concise market story for each of our key constituents. The Manager, Strategic Market Advancement will assess and support OptumCare markets to implement an optimized set of appropriate ancillary service lines (including, but not limited to, Oncology, Infusion, Surgery, Radiology, Home Health, PT, Lab, and Pharma) into their business. This will be achieved through assessment of existing internal and prospective external capabilities for performance, financial opportunities and market analysis. The future ancillary service line strategy by market will be designed inclusive of opportunity/gap analysis, recommendations, approach, and key considerations. This position will focus on identifying, sizing, pilot/testing new service lines and business models in pursuit of partnering with local markets to develop a full ambulatory care network strategy analysis. This position will primarily be focused on OptumCare (including support, recommendations related to potential service line opportunities, execution plans, value propositions, etc.) --- as such, this will include close collaboration with leaders and operators at the national and market level of all OptumCare entities including: CDOs, MedExpress and SCA. When and where appropriate, collaboration across broader OptumHealth, Optum and UnitedHealthcare should and will exist. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Develop business-level goals focused on maximizing service line performance that can be turned into specific operating and business plans that are executed at the local market level Ensure that service line strategies address applicable market expectations (e.g., patients, payers, providers, external business partners) Collaborate with market partners - build long-lasting transparent and trusting relationships Create strong partnerships across all levels of the organization to obtain needed information and support across teams Present complex information/insights in a simple and consumable format Collaborate with applicable stakeholders to obtain appropriate market information/data (e.g., marketing, sales, health plan partners, channels, shared services) Gather/analyze/validate applicable data from internal and external sources to identify market characteristics/needs/problems (e.g., market opportunities, financials, trends) Document clear and concise information on the vision and opportunity offered by OptumCare for use with internal and external partners Creating operational playbooks to enable scale of solutions Partner with vendors and other SMEs to ensure accuracy of information and proposals. Examples include: identification of vendors, vetting vendors/solutions, understanding of program operations, validation of pro forma business cases, reviewing financials, identifying collaboration opportunities Monitoring pilots and tests including program design, metrics to track, and overall project management to launch and implement these pilots Analyze internal data, alongside external data sets (including Medicare claims and external payer data sets) to identify patterns of clinical care and referrals; and cost savings opportunities Use above analyses to create business pro formas to size opportunities – including calculating metrics for revenue, EBITDA, ROIC, and IOI Review and assess completed analysis; seeking clarity, questioning where appropriate, and working collaboratively to drive accurate results Work directly with and across OptumCare business units to help determine needs and solve complex and strategic business challenges Translate executive vision into pragmatic execution; ensuring a successful hand off from strategy to operations Ensure consistency and coordination in how key service lines/initiatives are implemented Make recommendations to management/leadership based on business case and analysis Required Qualifications: Bachelor's Degree 3+ years of relevant work experience in a healthcare or managed care environment working with large data sets, with ability to seek and analyze data to identify solutions 3+ years of health care industry experience Advanced level of proficiency in MS Excel At least an intermediate proficiency in MS PowerPoint Preferred Qualifications: Experience with SQL Management Studio and/or Tableau Experience working with financial metrics Experience working with data related to specialists and/or ancillary services Proven success working in a fast-paced, rapidly changing, complex, matrixed environment Interpersonal skills, including positive assertiveness, professional communication, relationship building and ability to influence without authority Excellent written and oral communication skills Strong problem solving capabilities Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm) *All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy 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. Job Keywords: healthcare, health care, strategy, strategic, analysis, data, financial, modeling, forecasting, Excel, SQL, Tableau, OptumCare, specialist, ancillary, telecommute, telecommuter, remote, work from home 72092bed-7182-4e64-a753-57fee8931a13 *Manager, Strategic Market Advancement - Telecommute* *Minnesota-Eden Prairie* *757166*
UnitedHealth Group Dallas, TX, USA
Apr 18, 2018
Position Description: Energize your career with one of Healthcare’s fastest growing companies. You dream of a great career with a great company – where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up. This opportunity is with one of our most exciting business areas: Optum –a growing part of our family of companies that make UnitedHealth Group a Fortune 6 leader. Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.The health care system is still evolving at a rapid pace. Technology is driving new advances in how patient care is delivered and how it's reimbursed. Now, UnitedHealth Group invites you to help us build a more accurate and precise approach to claims adjudication. As part of our Recovery and Resolutions team, you'll help understand and overcome errors in claims processing. You'll have all the tools and backing you need to help manage subrogation files, negotiate settlements and ensure adherence to compliance policies. All the while, you'll be building your career with a leader and reaching for the highest levels of performance as you do your life's best work.This is a challenging role with serious impact. You'll need to sort through complex situations to understand and clarify where errors happened or where they may continue to happen. It's a fast paced environment that takes focus, intensity and resilience.Positions in this function are responsible for investigating, recovering and resolving all types of claims as well as recovery and resolution for health plans, commercial customers and government entities. May include initiating telephone calls to members, providers and other insurance companies to gather coordination of benefits data. Investigate and pursue recoveries and payables on subrogation claims and file management. Process recovery on claims. Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance. May conduct contestable investigations to review medical history. May monitor large claims including transplant cases.Primary Responsibilities: Provide claims expertise support by reviewing, researching, investigating, negotiating and resolving all types of claims as well as recovery and resolution for health plans, commercial customers, and government entitiesAnalyze, identify trends and provide reports as necessaryEnsure adherence to state and federal compliance policies, reimbursement policies and contract complianceManage subrogation filesExtensive work experience, possibly in multiple functionsWork does not usually require established proceduresWorks independentlyMentors othersActs as a resource for othersCoordinates others' activities Required Qualifications: High School Diploma / GED (or higher) 1+ years of experience within the health insurance industry Experience with computer research Proficiency within Microsoft Excel (pivot tables, v look ups, formulas, filter, sort) Preferred Qualifications: Associate's Degree (or higher)Familiar with CPT code terminology Experience with one or more of the following: claim processing, provider demographic information or insurance billing practices Certified coder Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.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.Keywords: UnitedHealth Group, UnitedHealth Care, Health care, insurance, computer research, microsoft excel 754eb18c-3d8f-469c-96ca-c5f6eb11d1af *SIU Pre - Pay Analyst - US Telecommute* *Minnesota-Minneapolis* *761441*
UnitedHealth Group Dallas, TX, USA
Apr 18, 2018
The more you do, the more you learn. And as you learn you find new doors opening that challenge you to bring your best. This Specialist role with UnitedHealth Group will call on your knowledge, your energy and your commitment to making health care work more effectively for more people. Today, more and more employers are turning to us for innovative ideas and high levels of performance. Now, we invite you to help us welcome new members as you help install assigned accounts. You'll be responsible for overall employer contract loading using various databases and/or source documents. Along the way, you'll discover the training, resources and opportunities you'd expect from a Fortune 6 leader. This is a challenging role with serious impact. It's a fast paced, high volume environment that requires you to work independently while maintaining a strong focus on company policies and guidelines. Your accuracy will be vitally important and monitored carefully to ensure our system is correctly coded and that all plan documents are precise. Primary Responsibilities: Set up and host meetings to fact-findClarify projects related to New Products, Advocacy, Correspondence servicesReview Test Plans and Proofs (correspondence implementations)Mock / Design, Update, and Implement Letter Changes Help manage Command Center activitiesWill include other duties as assigned to you. Requirements: HS Diploma or GED1+ years of experience in business analysis collecting, analyzing, and presenting data and recommendations to managementMathematical experience in a healthcare environmentRetail pharmacy or PBM experienceExperience utilizing Prior Authorization processing platformsAdvanced writing and proofreading experienceIntermediate level of proficiency with PC based software programs and automated database management systemsExperience with MS Office programs including: Excel (ability to create a spreadsheet, filter, and sort), PowerPoint (ability to create and review a presentation), Adobe (ability to save, edit and work with attachments), and Word (ability to work with tables, page layouts, page breaks) Preferred Qualifications: National Pharmacy Technician certification Soft Skills: Ability to work as an individual and within a team environmentUnitedHealth Group is a team of more than 260,000 people who are building career success through commitment, compassion and a desire to make a difference. Join us. Learn more about how you can start doing your life's best work.SM OptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do. If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let's talk about smart, motivated teams. Let's talk about more effective and affordable healthcare solutions. This is caring. This is great chemistry. This is the way to make a difference. We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance. Join us and start doing your life’s best work.SMDiversity 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. Keywords: UHG, OptumRX, Prior Authorization, Client Letters, Written Correspondence, US Telecommute 31c0b09a-d38e-4c60-97ae-b37b1ad85437 *Employer Installation Specialist - US Telecommute* *Minnesota-Minneapolis* *758727*
UnitedHealth Group Dallas, TX, USA
Apr 18, 2018
Great sales are the result of strong purpose, conviction and pride - pride in your ability and your product. UnitedHealth Group offers a portfolio of products that are greatly improving the life of others. Bring along your passion and do your life's best work.(sm) You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Manages client relationship for ChargeMaster clients including training and ongoing support. Represents client internally and coordinates with other functions to implement client systems, complete projects, and address ongoing service needs impacted. This role will work closely with sales on renewals and up-selling, but incumbents do not have specific sales goal accountability. Employees in this role are responsible for supporting clients requiring an advanced level of knowledge and experience. This role will provide support on Chargemaster which is a list of all the billable services and items to a patient or a patient’s health insurance provider. The chargemaster captures the costs of each procedure, service, supply, prescription drug, and diagnostic test provided at the hospital, as well as any fees associated with services, such as equipment fees and room charges. Chargemaster provides customer support for Information Technology related issues in designated areas of the health system. Primary Responsibilities: Technical working knowledge of customers daily operations to ensure superior technical support to support clients and trouble shoot issues Identifying process improvements based on customer's needs and troubleshooting and providing client support for systems and applications. Participate in Client Project Management from inception to completion Travel to perform client presentations and/or provide SME support Acquire, receive and track receipt of multiple data files types to determine its use within internal tools and software products, to ensure the products and services provided to customers are up to date and accurate. Filter and “cleanse” data, reviewing outputs and correcting problems to ensure compliance with internal and external requirements, to ensure the products and services provided to customers are up to date and accurate. Providing summaries of any yearly coding changes that will impact each department Required Qualifications: Minimum of 4 years of experience working with revenue cycle management in a hospital, clinic, medical office, business services, revenue cycle organization, insurance industry, information technology and/or consulting Outstanding communication and presentation skills Client Management experience (direct or indirect) with ability to drive things to completion in a highly matrixed organization Advanced judgment and decision making skills Ability to resolve issues at lowest level and understand when to escalate or change priorities Must have computer skills and dexterity required for data entry and retrieval of required job information Must be proficient with Windows-style applications and keyboard Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout required job processes Strong analytical and operational problem solving skills Ability to conceptualize and develop operational improvement plans in coordination with Internal Consultants Strong time management skills; ability to prioritize, organize and coordinate multiple work areas and assignments under fast paced and changing conditions to meet deadlines Ability to travel 30% Preferred Qualifications: Direct experience in Revenue Cycle related to Charge Capture or Charge Master Ability to understand and explain the complexities of charge capture as it relates to coding, compliance and regulations, billing, payer contracting, reimbursement and finance Related professional certification (e.g. CIA, CPA, CISA, CPC, CPC-A, CCS, Epic, etc.) HIGHLY DESIRED SPECIFIC SKILLS: Chargemaster maintenance in Invision, Soarian, or Cerner Craneware. System maintenance in Invision, Soarian, or Cerner. System maintenance in other Healthcare Finance or IS systems like McKesson, Epic, Allscripts, Meditech, etc. Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world?s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm) *All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy 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. Job Keywords: chargemaster, revenue cycle, Eden Prairie, MN, Minnesota, Nashville, TN, Tennessee, Philadelphia, PA, Pennsylvania, Denver, CO, Colorado, Chicago, IL, Illinois, Phoenix, AZ, Arizona 55993455-4498-4c23-b3e0-7848a7c7bfd7 *Chargemaster Client Specialist - Optum 360 - US Telecommute* *Minnesota-Eden Prairie* *752987*
UnitedHealth Group Nashville, TN, USA
Apr 18, 2018
There's no better time to bring your software engineering career to the health care industry.You take pride in designing and developing solutions. And not just any solutions--solutions that are scalable and can be used in the marketplace to make an impact on the lives of millions. At Optum, you can bring your passion for innovation to an Agile environment where some of the smartest people you'll ever work with are working together to help make the health care system work better for everyone. When you join us as a Senior Software Engineer, you'll have the opportunity to showcase your technical expertise, making historic transformation in health care and changing the way our businesses and consumers engage with technology. You will be challenged with delivering high quality software products to impact the health care industry for the better. Here, you'll work at a pace you didn't know you had in you, your performance will be rewarded and, at the end of the day, you'll know you're doing your life's best work.(sm)Primary Responsibilities: Perform all phases of software engineering including requirements analysis, application design, code development and testing Design and implement product features in collaboration with business and IT stakeholders Design reusable components, frameworks and libraries in alignment with organization architectural roadmap Work very closely with architecture groups and drive solutions that are in alignment Participate in an DevOps and Agile/Scrum methodology to deliver high-quality software releases to PROD in days or weeks through Sprints and CI/CD pipelines Review code and provide feedback relative to best practices and improving performance Troubleshoot production support issues post-deployment and come up with solutions as required - solve complex production issues Function as a mentor for junior engineers, providing assistance where needed and fostering accountability Drive Quality engineering in all phases of lifecycle including Requirements definition, Unit, Functional, Non-Functional, Regression, Integration and Performance testing, maximizing automation and ROI Required Qualifications: 5+ years of software development 5+ years of JavaScript or C# .NET 2+ years of Angular 2.0 or higher 3+ years agile experience API experience - RESTful Services 3+ years experience with MS SQL or MySQL 6 months of cloud experience Bachelor's degree or equivalent work experience Ability to work in Franklin, TN office Preferred Qualifications: Protractor, Karma and Jasmin OpenShift DevOps - CI/CD Prior architecture experience Big data experience Test Automation experience Angular 4.0 experience Technology Careers with Optum. Information and technology have amazing power to transform the health care industry and improve people's lives. This is where it's happening. This is where you'll help solve the problems that have never been solved. We're freeing information so it can be used safely and securely wherever it's needed. We're creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life's best work.SM 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. Keywords: JavaScript, C#, .NET, API, DevOps, Franklin, TN ce97ba64-8b65-4551-b39e-c987ba437b74 *Senior Software Engineer - Franklin, TN* *Tennessee-Franklin* *762989*
UnitedHealth Group Franklin, TN, USA
Apr 18, 2018
Great sales are the result of strong purpose, conviction and pride - pride in your ability and your product. UnitedHealth Group offers a portfolio of products that are greatly improving the life of others. Bring along your passion and do your life's best work.(sm) You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Manages client relationship for ChargeMaster clients including training and ongoing support. Represents client internally and coordinates with other functions to implement client systems, complete projects, and address ongoing service needs impacted. This role will work closely with sales on renewals and up-selling, but incumbents do not have specific sales goal accountability. Employees in this role are responsible for supporting clients requiring an advanced level of knowledge and experience. This role will provide support on Chargemaster which is a list of all the billable services and items to a patient or a patient’s health insurance provider. The chargemaster captures the costs of each procedure, service, supply, prescription drug, and diagnostic test provided at the hospital, as well as any fees associated with services, such as equipment fees and room charges. Chargemaster provides customer support for Information Technology related issues in designated areas of the health system. Primary Responsibilities: Technical working knowledge of customers daily operations to ensure superior technical support to support clients and trouble shoot issues Identifying process improvements based on customer's needs and troubleshooting and providing client support for systems and applications. Participate in Client Project Management from inception to completion Travel to perform client presentations and/or provide SME support Acquire, receive and track receipt of multiple data files types to determine its use within internal tools and software products, to ensure the products and services provided to customers are up to date and accurate. Filter and “cleanse” data, reviewing outputs and correcting problems to ensure compliance with internal and external requirements, to ensure the products and services provided to customers are up to date and accurate. Providing summaries of any yearly coding changes that will impact each department Required Qualifications: Minimum of 4 years of experience working with revenue cycle management in a hospital, clinic, medical office, business services, revenue cycle organization, insurance industry, information technology and/or consulting Outstanding communication and presentation skills Client Management experience (direct or indirect) with ability to drive things to completion in a highly matrixed organization Advanced judgment and decision making skills Ability to resolve issues at lowest level and understand when to escalate or change priorities Must have computer skills and dexterity required for data entry and retrieval of required job information Must be proficient with Windows-style applications and keyboard Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout required job processes Strong analytical and operational problem solving skills Ability to conceptualize and develop operational improvement plans in coordination with Internal Consultants Strong time management skills; ability to prioritize, organize and coordinate multiple work areas and assignments under fast paced and changing conditions to meet deadlines Ability to travel 30% Preferred Qualifications: Direct experience in Revenue Cycle related to Charge Capture or Charge Master Ability to understand and explain the complexities of charge capture as it relates to coding, compliance and regulations, billing, payer contracting, reimbursement and finance Related professional certification (e.g. CIA, CPA, CISA, CPC, CPC-A, CCS, Epic, etc.) HIGHLY DESIRED SPECIFIC SKILLS: Chargemaster maintenance in Invision, Soarian, or Cerner Craneware. System maintenance in Invision, Soarian, or Cerner. System maintenance in other Healthcare Finance or IS systems like McKesson, Epic, Allscripts, Meditech, etc. Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world?s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm) *All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy 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. Job Keywords: chargemaster, revenue cycle, Eden Prairie, MN, Minnesota, Nashville, TN, Tennessee, Philadelphia, PA, Pennsylvania, Denver, CO, Colorado, Chicago, IL, Illinois, Phoenix, AZ, Arizona 55993455-4498-4c23-b3e0-7848a7c7bfd7 *Chargemaster Client Specialist - Optum 360 - US Telecommute* *Minnesota-Eden Prairie* *752987*
UnitedHealth Group Philadelphia, PA, USA
Apr 18, 2018
There's an energy and excitement here, a shared mission to improve the lives of others as well as our own. Nursing here isn't for everybody. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Start doing your life's best work.(sm) If you are located in Philadelphia or Pittsburgh, PA, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: Collaborate with appropriate department to document, investigate and resolve formal or informal member complaints and appeals in accordance with plan and state policies and procedures and requirements Review and analyze reports, records, and medical documents/charts Prepare reports and records on work function activities and projects Coordinate quality management and HEDIS related programs and activities as required Supports quality improvement programs requesting records from providers, maintaining databases, and researching to identify members' provider encounter history Participates in and represents plan at community, health department, collaborative and other organizational meetings focusing on quality improvement, member education, and disparity programs, as assigned Performs, provider and/or member outreach as required Participates in or coordinates with other department projects as needed Some travel to job related meetings and activities is required Required Qualifications: Clinical RN with current, unrestricted license in PA 1 year of clinical experience 1+ year working in managed care or in the insurance industry Experience with Medicaid and/or Medicare Knowledge base of clinical standards of care, preventive health standards, HEDIS, NCQA, governing and regulatory agency requirements Experience with project coordination Proficiency in software applications that include, but are not limited to, Microsoft Word, Microsoft Excel, Microsoft PowerPoint Ability to evaluate medical records with attention to detail and prepare reports as needed Preferred Qualifications: 1+ year of experience working with Grievance and Appeals Demonstrated ability to assist with focusing activities toward a strategic direction as well as develop tactical plans, drive performance and achieve targets Strong organizational skills and ability to interact with company staff at all level Ability to do formal presentations in different settings-reporting on projects and reports that have been created and analyzed Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm) *All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy. 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. Job Keywords: RN, HEDIS , Quality, nurse, Quality improvement, Project management, project coordination, Appeals and Grievances,, NCQA, Medicare, Medicaid, Telecommute, Telecommuter, Telecommuting, Remote, Pittsburgh, Philadelphia, Pennsylvania, PA 4fa74a72-3154-4fb1-a0ad-f197a123baa2 *Clinical Quality RN - Pittsburgh, Philadelphia* *Pennsylvania-Pittsburgh* *760829*
UnitedHealth Group Pittsburgh, PA, USA