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Workstream Lead - Claims Encounters - Telecommute

Employer
UnitedHealth Group
Location
Minneapolis
Salary
94500.00 - 171700.00 USD Annual

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Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

Optum State Government Solutions implements and operates a range of business services supporting State Governments. Client engagements include multiple Optum services that are internally provided by different teams and delivered in a matrix environment. The Business Lead role is designed to ensure alignment of the overall solution with the State client's requirements and goals, using the Implementation team and Optum State Government resources.

The ideal candidate has extensive experience as a delivery professional managing relationships with State or Federal government executives in both implementation and on-going operations phases of large government health services contracts. This candidate will be an established leader with operational credibility and experience in the areas of implementing business service operations and Medicaid Management Information Systems (MMIS) or commercial off the shelf solutions (COTS), and leading efforts that bring best possible solutions to the marketplace.

The role will transition to on-going operational management of the implemented services after the go-live date. The role will also foster, and support business development activities related to enhancements or additional scope. This individual will have strong executive presence and be able to clearly discuss and communicate product value and benefits to customers, prospects, and internal and external partners.

You will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Establish and implement appropriate team structure to complete program implementation
  • Establish and maintain positive relationships with the client's executive leadership
  • Establish and maintain positive relationships with various Optum and UnitedHealthcare delivery teams
  • Establish and manage the Model Office process, driving alignment on requirements and functionality
  • Developing Business Requirements and upkeeping requirement documentation
  • Performing demonstrations of the Facets Claims system for client review during Model Office sessions and for quarterly releases of the solution.
  • Deliver results with efficiency, quality, and customer value; measure and report result to the client and to Optum stakeholders
  • Engage client and Optum stakeholders to manage risks and timely resolution of issues
  • Ensure in scope deployments are completed on time and per contract requirements
  • Ensure operational services are delivered with quality and within KPI and SLA requirements
  • Prioritize multiple demands and ideas based on available resources and client commitments
  • Support decisions and act quickly and effectively to sustain progress
  • Navigate and influence multiple cross-functional teams (both clients, Optum and United Healthcare) in a complex work environment
  • Foster and support business development opportunities while engaged with the client

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 equivalent experience
  • 3+ years of demonstrated experience working within a State Medicaid Agency or MMIS/fee for service vendor
  • 3+ years of demonstrated experience in implementation project management
  • 2+ years of experience managing project controls including issues, risks, requirements, scope, schedules
  • Experience maintaining visibility on day-to-day activities with project teams and ensuring sufficient facetime with key executive stakeholders
  • Experience engaging in government RFP responses and SOW activities
  • Experience in the healthcare operational services industry
  • Demonstrated experience partnering with stakeholders (client and internal) to ensure the proper strategy, plan, alignment, integration, and visibility
  • Demonstrated experience with encounters and capitation processes
  • Medicaid Management Information Systems (MMIS) or commercial off the shelf products and related solutions experience
  • Understanding of front-end operations within claims processing
  • Understanding of Federal/CMS/State regulations, requirements, and processes
  • Willingness and ability to travel as required up to 50%

Preferred Qualifications:

  • Advanced industry degrees or MBA
  • Experience serving as a consultant to government clients
  • Experience in a fiscal agent or MMIS/fee for service vendor
  • Experience with Facets claims adjudication system
  • Ability to balance strategic thinking with the urgency to drive work forward
  • Ability to manage self in addition to managing others work tasks and priorities
  • Highly skilled in communications (both verbal and written), negotiation, and conflict management

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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)

Colorado Residents Only: The salary range for Colorado residents is $94,500 to $171,700. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.

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

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.

Job keywords: Workstream Lead, Claims Encounters, State Medicaid Agency, MMIS, RFP, SOW, MMIS, Federal, CMS, State regulations, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, WAH, Plymouth, MN, Minnesota

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