Government Dental Programs Operations Consultant - Telecommute

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

Positions in this function conduct and manage outcomes of various studies that include analyzing, reviewing, forecasting, trending, and presenting information for operational and business planning. They support short and long term operational/strategic business activities - by developing, enhancing and maintaining operational information and models. They also develop and implement effective/strategic business solutions through research and analysis of data and business processes.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Apply Department's process standards to satisfy intake request business requirements
• Assess requirements and documents for thorough process or project impact
• Understand and apply business logic applicable to benefit plan change requests and claims administration systems update requests
• Handle mid-level projects independently
• Coordinate and conduct meetings with internal customers and vendor staff
• Maintain established quality levels and turnaround times
• Ability to work independently to maintain acceptable quality levels including timely communications of any issues and / or required information in order to complete plan requests within production turnaround time guidelines
• Generate supporting materials for clients including implementation guides, system reference documents, and standard customer correspondence
• Serves as SME for key vendor processes and business requirements
• Provides status reporting, communication, escalation and meeting management
• Serves as a technical consultant for key data exchange processes including:
  • Encounter Data (Outbound and rejection/reconciliation processes)
  • EGC/data exchange jobs and processes
  • Provider Data Interchanges
  • Eligibility workflow
  • Reviews data schema and provides direction to report developers for requirements
  • Ad hoc data exchanges and reporting
• Participate in team meetings
• Implement quality process to thoroughly test and troubleshoot systems change requests
• Create process documentation, process maps/process flow diagrams to fully document standard operational procedures
• Maintain access for internal partners to key vendor systems
• Maintain exceptions process for vendor systems related to access in secure
• Maintains system files and documentation on workflow processes
• Functionally own CMS reporting universe creation and QA process for Medicare
• Perform rules table updates and distribution
• Complete mapping of products from internal system to vendor systems to ensure accurate transmission of data
• Own Medicare member notice compliance and maintenance processes in Facets and vendor systems
• Perform other duties as assigned

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 work experience
• 3+ years of Operational Support, Business Analysis or Project Management experience
• 2+ years of experience working with vendor relationships
• 2+ years of experience managing projects involving operational initiatives
• Intermediate Excel skills (Ability to manipulating data, Pivot tables, analysis features)
• Ability to work with reporting systems such as Business Objects, and produce basic reports or extracts of data
• Operations experience within a matrix organization

Preferred Qualifications:

• Bachelor's Degree (or higher)
• Healthcare administration or healthcare benefits administration experience
• Experience working in the Healthcare insurance industry and experience with Healthcare or benefit management products
• Experience with Microsoft PowerPoint with the ability to create, modify, and customize documents
• Experience with Microsoft SharePoint including site navigation, project methodology, site hierarchy and content, working with views and data selection, adhering to required check - out / in procedures
• Analytical Skills
• Highly detail-oriented
• Ability to independently time-manage and prioritize
• Ability to multitask
• Ability to adapt and work in a changing environment
• Active Matrix Organization and Team participant

Physical Requirements and Work Environment:

• Frequent speaking, listening using a headset, sitting, use of hands / fingers across keyboard or mouse, handling other objects, and long periods working at a computer
• Open office center environment with moderate noise level, due to computers, printers, and floor activity
• Ability to work remotely/telecommute effectively

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)

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

Colorado, Connecticut or Nevada Residents Only: The salary/hourly range for Colorado residents is $66,100 to $118,300. The salary/hourly range for Connecticut/Nevada residents is $72,800 to $129,900. 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.

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:Operations experience, Business Analysis, Healthcare Administration, Healthcare Insurance, matrix organization, Project Management, Telecommute, Telecommuter, Remote, Work from home