Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start
Caring. Connecting. Growing together. You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities: - Provide direct support to the Medicaid Risk Submissions Manager and the suite of clients leveraging the submission product
- Lead all ad hoc analyses requested by management to identify issues, data trends, and investigate discrepancies in data submissions
- Provide insightful analysis to solve business problems encountered
- Serve as SME for the inner workings of the Medicaid submission product
- Mobilize thought processes or requests into actionable tasks
- Support Medicaid Submission KPIs and ensure operational excellence
- Serve as primary liaison in establishing, enacting, and performing all control reporting and reconciliation required of our submission product
- Perform root cause analysis to identify any issues in current operational processing
- Assist on special projects requested by leadership
- Provide Subject Matter Expertise within Medicaid Submissions
- Provide consultative approach to clients leveraging deep knowledge of Medicaid submissions, including awareness of changing industry landscape, trends, and regulations
- Serve as 837 and EDI expert, assisting clients with EDI-related file submission issues
You'll 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: - 3+ years of work experience in Medicaid Risk Adjustment submissions
- 3+ years of work experience in gathering, analyzing, and reporting on data
- Intermediate SQL and Microsoft Excel skills
- Advanced knowledge of Medicaid submission lifecycle
- Advanced organizational and interpersonal skills, ability to work and present effectively with all levels of leadership, as well as business partners in other UHG entities
- Experience of planning projects from inception to closure and preparing status updates
- Demonstrated ability to self-manage workstreams with limited input from a direct supervisor
Preferred Qualifications: - Bachelor's Degree or related experience
- Medicare Risk Adjustment experience
All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for this role is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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, you'll find a far-reaching choice of benefits and incentives.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Diversity creates a healthier atmosphere: UnitedHealth Group is an 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. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment