Remote Associate Director Prepay Claims Optimization

UnitedHealth Group; Plymouth (MN); Híbrido; USD 113.000 - 193.000; Jornada completa

Descripción de la vacante

UnitedHealth Group is seeking an Associate Director to lead client-facing operational delivery for pre-pay and post-pay claims review services across multiple commercial clients. You will work with Operations, Clinical and other teams to drive significant savings and ensure program success.

You will have remote-friendly work with in-office four days weekly in Minneapolis or Washington, D.C. and may coordinate globally.

Formación

• 5+ years of operational management experience.
• 5+ years of client-facing experience and ongoing operational support.
• 3+ years of experience within the Fraud, Waste, and Abuse space.
• 3+ years of experience with workforce management and staff planning.
• 3+ years of experience indirectly leading a global team.
• 3+ years of experience developing and managing operational metrics.
• 3+ years of experience working within a health plan and/or managed care business operation.
• Certified Coder or RN/LPN (Preferred).

Responsabilidades

• Accountable for Inventory, SLAs, productivity via capacity analysis and quality control.
• Lead project and relationship management for one or more large, multi-year contracts with QA for services delivered.
• Identify and manage system issues, data integrity, security controls, and process adherence.
• Work with matrix partners to manage client contract obligations and deliverables.
• Achieve savings, revenue and IOI targets by staffing planning and identifying efficiency opportunities.
• Provide account management and partner with sales to ensure proper client follow-up.
• Drive favorable algorithm outcomes by partnering with R&D to optimize savings and revenue.
• Ensure adherence to state and federal compliance policies and contract requirements.
• Identify and remove operational barriers; conduct deep-dive reviews for improvement.
• Partner with offshore operations to integrate practices and reduce costs.
• Identify and secure resources (funding, staffing, security, real estate, telecommuting).
• Conduct regular meetings with stakeholders to review updates and issues.
• Monitor ongoing compliance and related outcomes for regulators and clients.
• Ensure business continuity and emergency response plans are tested and updated.
• Demonstrate budgeting/forecasting and cost-control capabilities.
• Analyze budget performance and variances; suggest adjustments.
• Collaborate with Finance and Workforce Management to plan resources and budgets.

Conocimientos

Operational management

Client-facing experience

Fraud, Waste & Abuse

Workforce management

Global team leadership

Operational metrics

Health plan operations

Budgeting & forecasting

Descripción del empleo

UnitedHealth Group is seeking an Associate Director to lead client-facing operational delivery for pre-pay and post-pay claims review services across multiple commercial clients. You will work with Operations, Clinical and other teams to drive significant savings and ensure program success.

You will have remote-friendly work with in-office four days weekly in Minneapolis or Washington, D.C. and may coordinate globally.