State Fair Hearing Coordinator - Work From Home

If you are located within the state of Minnesota, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges.

Let's talk about diplomacy. Let's talk about accuracy. Let's talk about how UnitedHealth Group became a Fortune 10 company leader in healthcare. We did it by working to become an undisputed leader in creating service quality and helping to improve the lives of millions. Now, here's where you come in. You can build on your problem-solving skills by taking on responsibility for reviewing, researching, investigating and triaging claims that were denied to determine their correct status. You'll drive the action and communicate with appropriate parties regarding appeals and grievance issues. In turn, we'll provide you with great training, support and opportunities.

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.

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

Primary Responsibilities:

• Research and resolve written complaints submitted to the state by consumers and/or physicians/providers
• Obtain additional documentation required for case review
• Review case to determine if review by clinician is required
• Complete necessary documentation of final determination
• Identify and resolve operational problems using defined processes, expertise and judgment
• Investigate claim and/or customer service issues as identified and communicate resolution to stakeholders
• Provide feedback to team members regarding improvement opportunities

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:

• Associate's Degree (or higher) with 2+ years of experience OR Bachelor's degree (or higher)
• 4+ years of Medicaid or Health Plan experience analyzing and solving State or customer problems
• Proficiency with Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications

Preferred Qualifications:

• Appeals or Intake experience
• Medical record or utilization management experience

Telecommuting Requirements:

• Reside within the state of Minnesota
• 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

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

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 at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in healthcare here. We serve the healthcare needs of low income adults and children with debilitating illnesses such as Cardiovascular Disease, Diabetes, HIV / AIDS and High - risk Pregnancy. Our holistic, outcomes - based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive Healthcare, Community, and Government partners to heal healthcare and create positive change for those who need it most. This is the place to do your life's best work. SM

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.

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