Position Description 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.
Primary Responsibilities:
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
Required Qualifications:
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
Preferred Qualifications:
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
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.
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