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UnitedHealth Group

UnitedHealth Group is looking for a Business Manager of Implementation Readiness – Telecommute  #FindJobPagosaSprings #JobSearchNearPagosaSprings #ManagerJobsPagosaSprings

Combine 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.(sm)OptumCares growth pipeline requires dedicated professionals to ensure the successful migration and implementation of new business onto its core claim processing platform. Additionally, it is critical that a seamless transition from implementation to operational steady state occurs. In this role, you will support that critical mission as a key leader on the OptumCare Configuration Implementation Team. As Business Manager for Implementation Readiness, you are responsible for managing and tracking the implementation deliverables required for member eligibility, provider configuration, and benefit configuration. Your role requires knowledge ownership of end to end business and technical processes across these 3 functional areas. You will work with a best in class project management organization focused on supporting market needs and operational success. You will be accountable for ensuring integrity of status communications/slideware, capacity and production plan accuracy, issue management and escalation, process engineering support, and providing visibility and transparency of implementation activities to all cross functional partners. Youll enjoy the flexibility to telecommute* from anywhere within United States as you take on some tough challenges.Components of the Cross-Enterprise business areas and functions Optum Care Delivery Operations:  Configuration (Plan, Benefit, Pricing / Fee Schedule) Eligibility (Member; load, maintain, reconcile) Provider Data (load, maintain, reconcile) Prior Authorization (intake and processing) Utilization Management Provider Service Center Claims Operations (intake, adjudication, research and adjustments, quality assurance / audits, encounter data reconciliation, claims automation) Operations Support Services (Training, Documentation, Testing) Project Management (PM, BA, Reporting) Market Operations (Service Account Management) Upstream and downstream Operational dependencies (Optum or Market operations) Network Strategy, Development and Management Provider Contracting Provider Credentialing Network / Provider Relations Patient Acquisition and Retention Medical Management (CM, DM, CCM) Print and Mail Room Operations Payment Integrity and Claims Editing Finance (Cap reconciliation, provider payment, EFT / ERA) Risk and Quality Regulatory Compliance Reporting Core Activities: Develop, own, and maintain strategic approach, educational overview, and going in position documentation which details the structure of key implementation and maintenance requirements Support Implementation Director in compiling hiring needs across the configuration operation to support new business and assist with budget adherence to approved hiring plans Own readiness reporting functions across member / benefit / provider to ensure a proven production plan is maintained at all times and is in alignment with actual work inventory deliverables. Claim Readiness reporting is the number one communication tactic to align all partners on 1 / 1 Go Live status  Support functional implementation leads on the team by aligning with Optum Implementation Resources (Project Managers / Business Analysts) to analyze operational requirements, identify gaps and draft solutions.  Facilitate (as needed to support team / leads) work-sessions with other Optum resources (Technology, Finance, others) to discuss requirements, dependencies and solutioning. Facilitate (as needed to support team / leads) activities to identify gaps, deliverables, timelines and required actions and owners Develop an implementation library (ex: default requirements language, standardized playbook processes, key handoff processes with operational staff) Arrange / coordinate and conduct weekly Executive and Operational Leaders Read-out Session and deliver an overview of the progress, risks, opportunities, and overall readiness scorecard reporting Act as an operational implementation SME on behalf of product / member / provider configuration Update and maintain all materials in appropriate locations Develop and maintain Best Practices and Lessons for use in future implementations. Partner with others to identify optimization for both implementation and maintenance with a goal of reducing the Optum Care Operations Delivery PMPM costsKey Competencies: Business, Market, Client and Customer focus Ability to explain value of capability Partners with SMEs Ability to learn operational business Financial Acumen Compiles analysis to support capital requests Understands the technologies used to deliver cross – business solutions to effectively inform direction and scope of opportunity across business Relationship Management Build a network of leaders inside and outside of organization; deepens relationships with key stakeholders Demonstrates understanding of formal and informal work roles, team goals, interests and relationships that make up the cross-group capability working team; Facilitates communication, considers multiple perspectives, and informs decisions necessary to implement initiatives; Plans, coordinates and manages internal resources to accomplish assignments within the given deadlines Leadership Influences both directly and indirectly Takes accountability Considers long – range objectives Critical Thinking Identify and gather relevant data; utilize data to evaluate solutions and challenges Applies operational rigor Adaptable Operated effectively with ambiguity; leverage internal network Youll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.Required Qualifications: 5+ years of experience in health plan operations such as claims operations, health plan configuration, utilization management, provider service center or similar operations 3+ years supporting projects as a Business Analyst, Project Manager, or other project leader capacity with health insurance lines of business such as Medicare Advantage, Medicaid, Commercial, Dual eligible plans Demonstrated understanding of the membership types, provider types & pricing, plan requirements and impacts on operations Demonstrated understanding of health plan operations lifecycle Advanced user of Visio and PowerPoint Intermediate user of Microsoft Office Suite to include Excel and Word If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking ordersPreferred Qualifications: Understands and articulates how capability aligns to business strategy and future roadmap; considers industry trends, target markets, lines of business Data and business process analysis and visualization Decision – making utilizing facts and criteria Document, iterate and manages artifacts across the full lifecycleCareers 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)Colorado Residents Only: The salary range for Colorado residents is $79,700 to $142,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, youll find a far-reaching choice of benefits and incentives.*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.Diversity creates a healthier atmosphere: OptumCare and its affiliated medical practices are Equal Employment Opportunity/Affirmative Action employers 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.OptumCare and its affiliated medical practices is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.Job Keywords: Health Plan Products Operations Manager, Operations, Prior Authorization, Provider Data, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, WAH, Minnetonka, MN, Minnesota Recommended SkillsProcess Analysis (Business)SchedulingMedicaidMedicare AdvantageManagementCredentialingRecommended JobsImplementation ManagerManagerAtlanta,GaManager, Atlanta,GaBusiness Manager of Implementation Readiness – TelecommuteUnitedHealth GroupWork From HomeFull Time
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