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About UHG

Careers at UnitedHealth Group

 

We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM

 

Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com

 

Job Category:

Medical and Clinical Operations

Country:

US

Postal Code:

91710

Approximate Salary:

Not Specified

Position Type:

Full Time

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UM Retro Review Coordinator - Ontario, CA

UHG - Ontario, California

Posted: 10/25/2018

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 14 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, and Performance.
 
Primary Responsibilities:
  • Must be flexible, well organized, self starter and a team player
  • Able to multi task
  • Plans, prioritizes, organizes and completes work to meet established objectives
  • Understanding of contracts and Health plan risk arrangements
  • Can proactively identify issues and present recommended solutions
  • Positions in this function are responsible for providing expertise and general support in reviewing, researching, investigating, negotiating and resolving all types of UM Retro Reviews initiated from claims and grievances
  • Communicates with appropriate parties issues, implications and decisions
  • Analyzes and identifies trends for appeals and grievances

Required Qualifications:
  • High School Diploma or GED
  • 1+ year experience in the Healthcare industry, preferably at the PMG/IPA UM and or Claims level
  • Knowledge of general PMG/IPA operations
  • Use of CPT, HCPC and ICD-9/10 code book
  • Working knowledge or Medical Terminology
  • Knowledge of Microsoft Office applications
Preferred Qualifications:
  • 1+ year understanding of contracts and Health plan risk arrangements
Soft Skills:
  • Ability to work effectively with physicians and ancillary staff, both written and verbally
  • Ability to be flexible
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.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.

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