If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm)
This is a key role in our strategy to deploy the Advanced Communication Engine (ACE) and ensure ACE is integrated in to a broader range of Payment Integrity processes. This role will be responsible for the ongoing growth of the ACE tool and the development of additional use cases that generate value to the enterprise.
UnitedHealthcare is seeking an individual with strong business process and operations experience. Innovation and creative thinking is a must. Ability to drive future ACE solutions and generate agreement across the enterprise is a key component of success with this position. This is an exciting opportunity to make key contributions to this highly visible and strategic program.
This position is responsible for identifying new edit opportunities and new use cases to expand the value realization associated with the ACE program. Interacts with Payment Integrity staff, line of business leaders, Benefit Operations, and O360 ACE program staff to identify new use cases. This role will assist in creating requirements for the use case and ensuring maximum positive impact is achieved. Makes recommendations for ACE strategic direction and roadmap to ensure a robust pipeline of enhancements. Calculates financial impact and benefit for new use cases.
This is a critical position to the success of the ACE program requiring a self - motivated individual who is responsible for managing the end-to-end processes associated with the seamless and quality rollout of the ACE solution.
Role will be focused on ACE expansion and the development of new edits and use cases that help the ACE program meet/exceed the value realization targets associated with the program.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
- Understand, through data analytics, how provider claim submission impacts business operations and customers’ experiences
- Present findings and conclusions clearly and concisely
- Collaborate with other departments and leaders to identify opportunities to improve performance using ACE
- Possess a proven ability to present solutions using both technical and non-technical
- Be service-driven to internal and external customers
- Be an innovative thinker with an innate curiosity around data and operations
- Be self-motivated and possess the ability to manage multiple priorities and meet deadlines
- Possess the capacity to work independently
- Adapts departmental plans and priorities to address business and operational challenges
- Influences or provides input to planning activities
- Determine scope of requested work in order to assess resource requirements and create work plans
- Demonstrate understanding of business terminology and acronyms in order to accurately interpret customers' request
- Be relentless in pursuit of opportunities and drive to closure
- Bachelor Degree
- 5+ years of experience in an Operations or Payment Integrity role
- Strong written and verbal communication skills
- Intermediate level of proficiency with Microsoft Office - Word, Excel, PowerPoint
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
- Knowledge of UnitedHealthcare lines of business (E&I, M&R, C&S)
- Ability to influence with and without direct authority
- Experience functioning in a matrix / shared services organization
*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: Advanced Communication Engine, Data Analytics, Business analyst, Connecticut, Minnesota, telecommute, Telecommuter