This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. This position is full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 6:00pm EST. It may be necessary, given the business need, to work occasional overtime. We offer weeks of on-the-job training. The hours of the training will be based on schedule or will be discussed on your first day of employment. Primary Responsibilities:
- Understand how various components in Facets fit together so claims pay correctly
- Utilize knowledge of benefit plans and documents to gather details to create/update applicable product configuration elements
- Collaborate with stakeholders to gather, assess, interpret and document customer needs and requirements
- Identify and analyze issues to provide solutions
- Design, configure and build various product / benefit components in Facets
- Research claims issues to determine configuration gaps, update configuration as applicable
- Audit configuration against benefit plan requirements / EOC, etc, verify configuration following source documentation
- Work with minimal guidance and supervision
- Serve as a resource to other team members
- Consistently meet established productivity, schedule adherence, and quality standards while maintaining expected attendance
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:
- High School Diploma / GED
- Must be 18 years of age OR older
- 2+ years of experience working with Medicare benefit configuration, claims issue resolution or other areas of Facets configuration
- 2+ years of experience working with Facets database tables and configuration
- Proficiency in Microsoft Word, Excel, and Outlook
- Computer proficiency including, but not limited to, ability to learn new computer system applications
- Oral and written communication skills
- Aptitude for working in a production driven environment
- Self-starter and able to work independently
- Ability to meet established productivity, schedule adherence, and quality standards while maintaining good attendance
- Ability to multi-task
- Ability to work in a fast-paced, dynamic, rapidly changing environment
- Ability to work full-time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 6:00pm EST. It may be necessary, given the business need, to work occasional overtime.
Preferred Qualifications:
- 2+ years of health insurer experience with medical plan case installation or benefit plan building
- 2+ years of health insurer experience handling provider billing/co-payments/co-insurance
- 2+ years of health insurer experience resolving provider claim issues
- Facets configuration experience
- Experience with Medicare medical benefit plans
- Experience with COSMOS or UNET or NICE
- Experience building and running SQL queries using tools such as MS Access, Query Builder, or similar
- Knowledge of supporting tools from Trizetto and other vendors such as CMU or similar applications
Telecommuting Requirements:
- Ability to keep all company sensitive documents secure (if applicable)
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.
Soft Skills:
- Interpersonal Skills - ability to deal and work with people with different backgrounds. Demonstrated ability to build and maintain long term internal business relationships
- Decision-Making Skills - capable of arriving at the appropriate decisions after weighing the pros and cons of all the options
- Communication Skills - excellent verbal and written communication skills in addition be a good listener to give value to the opinion and suggestion of others
- Accountability - Takes ownership of tasks, performance standard and quality results. Maintains necessary attention to detail to achieve high level performance
- Problem Solving - Solution Driven Approach Skills - demonstrate ability to review problem, troubleshoot root cause issues and determine path to resolution
- Flexible - Able to work effectively in a changing environment and contribute innovative ideas
- Accuracy and Efficiency - Excellent time management and organizational skills balancing multiple priorities. Accurate when processing detailed tasks while meeting deadlines
- Self-starter, able to independently, drive work and prioritize work with minimal oversight
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 - $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 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. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO
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