Sr. Benefits Manager - Individual and Family Plans

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life's best work.(sm)

Individual and Family Plans (IFP) is a growing business within UnitedHealthcare. The Sr. Benefits Manager, IFP is responsible for managing key IFP Product deliverables, including ensuring benefit information is clear, accurate, consistent, and delivered timely to internal partners. This individual will serve as a subject matter expert on IFP benefits for their respective markets, with responsibility for translating IFP plan designs and policies (i.e., Certificates of Coverage) into detailed business requirements, ensuring benefits are implemented accurately and timely, investigating and responding to internal benefit inquiries, and supporting claims testing activities. Applicants should be interested in developing a growing team within a start-up environment, be able to collaborate cross-functionally, and enjoy deriving structure and clarity from ambiguous and complex inputs.

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

Primary Responsibilities:

• Future Accountability for hiring, onboarding, training, developing, engaging, and managing a high-performance team
• Develop and document policies and relevant background information for other departments to better understand plan designs and benefit intent
• Translate plan design strategy and policies (i.e., Certificates of Coverage) into detailed requirements for benefit configuration
• Coordinate with IFP Product team members to ensure accurate, clear, and consistent benefit requirements across regions
• Manage plans and benefits hand-offs to internal and external partners; develop and manage change control processes
• Partner with Product Management & Regulatory Alignment, operational, clinical, and configuration teams to achieve benefit design solutions that align with plan design strategy and business requirements
• Serve as the IFP Product lead on claims testing and quality assurance activities for assigned markets, informing test plans and assisting in defect resolution
• Provide subject matter expertise to address escalated benefit inquiries and complex benefit-related issues
• Identify opportunities to improve processes and build best practices for efficient and effective translation of product strategy/plan designs into configuration requirements
• Demonstrate systems thinking to readily identify downstream impacts of decisions

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:

• Undergraduate degree or equivalent experience
• 5+ years of relevant healthcare experience
• 3+ years of relevant experience in a health insurance product implementation, benefit/coverage policy development, benefit configuration, or claims role
• Proficient in health plan benefit/coverage concepts
• Working knowledge and experience with medical coding (HCPCS, CPT, ICD-10)
• Proficiency in Microsoft Office applications
• Preferred Qualifications:
• Medical Coding Certificate: RHIT or CPC by AAPC or AHIMA license
• 1+ years of leadership experience
• Experience in the development or application of benefit interpretation guidelines, coverage policies, and/or reimbursement policies
• Experience working collaboratively across multiple functional areas (e.g., operations, configuration, clinical, IT, plan design) and fostering teamwork
• Experience interacting and effectively communicating with senior leadership
• Working knowledge of ACA market requirements (e.g., essential health benefits)
• Knowledge of On/Off-Exchange Individual and Family Plans
• Ability to use data and analytical thinking to make fact-based decisions and/or recommendations
• Able to balance strategic thinking with the urgency to drive work forward
• Solid problem-solving skills and ability to derive structure and clarity from ambiguous or open-ended inputs
• Solid communication skills (written, oral and presentation skills)

Careers with UnitedHealthcare. Work with a Fortune 5 organization that's serving millions of people as we transform health care with bold ideas. Bring your energy for driving change for the better. Help us improve health access and outcomes for everyone, as we work to advance health equity, connecting people with the care they need to feel their best. As an industry leader, our commitment to improving lives is second to none.

Colorado, Connecticut, Nevada, or New York City Residents Only: The salary range for Colorado residents is $97,300 to $176,900. The salary range for Connecticut/Nevada/New York City residents is $97,300 to $176,900. 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.

All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

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 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.