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CapDel Risk Issue Resolution E2E Process Lead - Remote

Employer
UnitedHealth Group
Location
Minneapolis
Salary
64800.00 - 116000.00 USD Annual

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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 life's best work. SM

This position will lead the end to end process improvement and infrastructure development efforts focused on the operational issues that arise with the transfer of financial risk from UHC to the provider entity. As these types of provider arrangements expand significantly, it is critical that the issue submission channels, as well as, the routing and resolution processes, operate effectively and efficiently. This position will serve as the CapDel operational lead to partner with the various internal business partners to develop the framework and process infrastructure to facilitate the optimal resolution of these issues.

This will improve the care provider experience by increasing their claims issue resolution turnaround time and will reduce the administrative burden that the provider risk issues place on both UHC and the delegated provider. This position will utilize their project management and analytical skills, as well as, extensive knowledge of the business and the business processes to implement this operational infrastructure.

This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of (8:00am - 5:00pm). It may be necessary, given the business need, to work occasional overtime.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Training will be conducted virtually from your home.

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Primary Responsibilities:

  • Develop appropriate end to end controls and monitoring of key capitation and delegation operational processes, including issue resolution.
  • Provide appropriate subject matter expertise and business analysis for projects related to establishing end to end infrastructure and processes across CapDel Ops.
  • Perform research to define and analyze business requirements for various systems/process improvements across CapDel Ops, including Implementation of standard operational issue submission channels for the capitated membership across all platforms.
  • Lead operational efficiency initiatives for CapDel Ops and partner with various internal business automation teams to execute effectively.
  • Lead collaboration with future state technology and capability development teams to ensure CapDel Ops represented optimally.
  • Develop/recommend solutions to identified CapDel business process problems/issues and measurement approaches/metrics to evaluate the effectiveness of recommended solutions/process changes.
  • Improve CapDel operational metrics to achieve Company standards.
  • Develop clear documentation of detailed root cause issues and process improvement opportunities that come about through the research of these risk transfer 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:

  • Bachelor's degree (or higher)
  • 3 years of experience using operational metrics, data/analytics, capacity planning, goals/objectives, and dashboards to run, interpret, and drive business performance
  • 3 years of experience developing and implementing business process change initiatives, including documentation
  • 3 years of experience with process improvement, workflow, benchmarking and / or evaluation of business processes
  • 3+ years of experience in communicating and presenting (verbal and written) complex operational information
  • 3+ years of experience leading/driving meetings and conversations
  • Intermediate proficiency with Microsoft office, including Word (create and edit) and Excel (Create, Edit, Pivot, formulas, VLOOKUP, run reports).

Preferred Qualifications

  • Experience in the Health Care industry
  • Knowledge of Value Based Contracting or Capitated Delegated Division of Financial Responsibility business models
  • Black Belt or equivalent experience

Telecommuting Requirements:

  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
  • Ability to keep all company sensitive documents secure (if applicable)
  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Soft Skills:

  • High proficiency in analytical skills, critical thinking, and problem analysis
  • Intellectually curious
  • Bias for action
  • High proficiency with relationship skills
  • Change Management experience
  • Ability to prioritize and effectively handle multiple priorities

Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible.

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

Colorado Residents Only: The salary range for Colorado residents is $64,800 to $116,000. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

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.

Keywords: UHG, claims, consultant, leadership, process improvement, claims processing, change management, project management, finance, data analytics, work at home, work from home, WAH, WFH, remote, telecommute, hiring immediately, #RPO

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