Project Manager - Claims Operations (Telecommute) - US at Minneapolis

Job Description

Position Description: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 lifes best work.Our claims operations, including our Senior Claims Business Process Consultants, are the focal point of handling information about services patients receive and the way those services get paid. Its complex, detailed work. Its fast paced challenge. Its a job that calls on you to be thoughtful, resourceful, team-driven and customer-focused. To put it mildly, there is never a dull moment.Primary Responsibilities:Implement claim payment processes that meet regulatory requirements and claim business rules.Conduct claims systems utilization, capacity analysis/planning and reporting, and claims-related business and systems analysis.Ensure data integrity, data security and process optimization.Serve as our internal Regulatory Affairs point of contactPartner with functional area leaders and SMEs to determine impact and solutionsImplement Claim ops solutions to meet regulatory requirementsLead Claim Ops market conduct or financial exam activity, corrective action plans responses and restitution projectsRemediate gaps in existing production processes that do not meet regulatory requirementsResponsible for all related aspects of claim system processes and claim business rules.Includes claims systems utilization, capacity analyses/planning and reporting. Includes claims-related business and systems analysis. Ensures data integrity, data security and process optimization.Reviews the work of others.Develops innovative approaches.Sought out as expert.Serves as a leader/ mentor.

Job Requirements

Requirements:High School Diploma/GED3+ years of Medical/Healthcare claims processing experience2+ years of Project Management experience2+ years of Supervisory or Team Lead experienceAny experience withState and Federal regulations that govern commercial health insurance claim paymentAdvanced level of Microsoft ExcelAssets:Knowledge of UNET, FACETS, Pulse and/or NICE internal claims processing platformsMS Access and Visio experienceTake the next step, online at: www.yourlifesbestwork.comUnitedHealthcare, part of the UnitedHealth Group family of companies, is comprised of three specialized businesses dedicated to meeting the health care benefits needs of individuals and groups; all part of something greater, but each with a specialized focus:UnitedHealthcare Employer & Individual works with individuals, small businesses and large multi-site employers to provide innovative, affordable benefits services.UnitedHealthcare Medicare & Retirement is focused on serving Americans over the age of 50. It is the largest business dedicated to meeting the growing health and well-being needs of aging individuals in the nation, serving one in five Medicare beneficiaries through a comprehensive and diversified array of products and services through four industry-leading businesses.UnitedHealthcare Community & State provides high-quality, personalized, public-sector health care programs that help local government agencies improve health outcomes for millions of children and low-income and disabled individuals at an affordable cost.Together, were removing the barriers that keep people from receiving the kind of quality health care that makes a difference. We focus on Integrity, Compassion, Relationships, Innovation and Performance as we empower people to achieve better health and well-being.Come grow and thrive in our culture of innovation and ideas. Because there is no opportunity greater than the quest to help people live healthier lives.Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/VUnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
Country: USA, State: Minnesota, City: Minneapolis, Company: UnitedHealth Group.