National Business Operations Consultant
UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.
Position Description:
You're empowered to do your best and to be a Strategic Resource! Join us to conduct and manage outcomes of various studies that include analyzing, reviewing, forecasting, trending, and presenting information for operational and business planning. Support short and long term operational/strategic business activities - by developing, enhancing and maintaining operational information and models. Develop and implement effective/strategic business solutions through research and analysis of data and business processes.
In this role, you will be responsible to lead, coordinate, and ensure completion of initiatives across various functional areas within the United Healthcare's government business segment, including claim processing, provider operations, call center, eligibility, enrollment, and IT. You will provide subject matter expertise and leadership in areas including healthcare operations, project management, project scope definition, risk identification, project methodology, resource allocation, facilitation, and other areas of expertise based on health plan and AmeriChoice functional knowledge and background. You will plan, develop and implement operations strategies and action plans to ensure operational contract compliance, with focus on ensuring optimal operational performance. This role reports to the Regional Director of Health Plan Operations with matrix accountability to plan and operational leaders.
Primary Responsibilities:
- Manage and coordinate change activities related to claim, call, enrollment and provider network operations functions from a national perspective for multiple health plans, ensuring operational contract compliance as defined by the state contract and ensuring business process optimization.
- Plan, develop, and implement operations strategies and action plans to ensure that scheduled strategies are met
- Coordinate with Regional and Local operational leaders throughout all phases
- Read, analyze, and interpret State contracts and Plan requirements, Plan and/or company policy and procedure and SOPs
- Effectively drive multi-functional teams to resolve Plan operational issues
- Serve as a resource to the Health Plans by effectively working the company matrix to obtain resources, solve problems, direct work, foster communication, and align accountabilities
- Establish and maintain effective working relationships with internal UHG operations business partners to ensure operational efficiencies and contractual requirements are met
- Develop and execute plans to improve existing performance and efficiency in operational processes
- Perform pro-active problem solving around global operational issues through constant efforts to reduce administrative costs and improve operational efficiency
- Lead large, complex projects to achieve key business segment objectives
- Provide expertise to the operational aspects of new product implementations to ensure adherence to standard processes.
- Perform special projects as assigned by Leader
UnitedHealthcare Community State, is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at UnitedHealthcare Community State.
We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.
This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.
You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.
Requirements:
- Bachelor's degree required
- 3+ years experience working with health plans within a call center, claim shop, health plan operations, or enrollment environment; i.e. someone who has worked within a health plan
- 3+ years of Medicare/Medicaid and/or long-term care experience; i.e. familiarity and understanding of regulations, benefits, etc.
- Intermediate level of proficiency with MS Word, Excel, and PowerPoint; i.e. Word - documentation purposes, Excel - task tracking and planning, creating spreadsheets, manipulating data; PowerPoint - creating slideshows from scratch
Assets:
- Experience in a Leadership and/or project management role is preferred
- Business process reengineering experience is preferred
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
Job Category: Business/Strategic Management
Reference Code: 369335
Position Type: Full Time, Employee