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Claims Business Process Consultant - National Remote - 2227019

UnitedHealth Group

UnitedHealth Group

Dallas, TX, USA · Tampa, FL, USA · Hartford, CT, USA · Minneapolis, MN, USA · Phoenix, AZ, USA
Posted on Monday, June 10, 2024

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

UMR, UnitedHealthcare’s third-party administrator (TPA) solution, is the nation’s largest TPA. When you work with UMR, what you do matters. It’s that simple . . . and it’s that rewarding.

In providing consumer – oriented health benefit plans to millions of people; our goal is to create higher quality care, lower costs and greater access to health care. Join us and you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system. Opportunities are endless for your career development and advancement within UMR due to our record-breaking growth.

Regardless of your role at UMR, the support you feel all around you will enable you to do what you do with energy, quality, and confidence. So, take the first step in what is sure to be a fast – paced and highly diversified career.

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 7:00 AM – 5:00 PM CST.

We offer weeks of paid training. The hours during training will be any 8-hour shift between 7:00 AM – 5:00 PM CST from Monday – Friday. Training will be conducted virtually from your home.

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

Primary Responsibilities:

  • Perform capacity planning and reporting
  • Claims related and business system analysis
  • Responsible for all aspects of quality assurance
  • Create and edit requirements, specifications, cost benefit analysis and recommendations to proposed solutions
  • Facilitate development of process documentation
  • Solves unique and complex problems with broad impact on the business
  • Participates in the development of business strategy
  • Develops and manages business plans to achieve objectives
  • Leads large, complex projects to achieve key business objectives
  • Directs cross-functional and/or cross-segment teams
  • Influences senior leadership to adopt new ideas, products, and approaches.

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 OR equivalent work experience
  • Must be 18 years of age OR older
  • 2+ years of experience with analyzing and solving customer problems in an office setting environment, using the telephone and computer as the primary instruments to perform job duties
  • 1+ years of experience managing complex projects
  • Experience with GEHA members
  • Moderate Proficiency with using computer and Windows personal computer applications, which includes the ability to learn new and complex computer system applications
  • Ability to work any of our 8-hour shift schedules during our normal business hours of 7:00 AM – 5:00 PM CST, Monday-Friday.

Preferred Qualifications:

  • 2+ years of current OR previous UMR CPS experience (UMR is UnitedHealthcare’s third-party administrator (TPA) solution) and candidate must be a previous or current employee of UMR / UHSS specifically to have the required experience with the UMR CPS system
  • Green Belt Six Sigma Certified
  • Proficiency in Smart Sheets

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:

  • Ability to multi – task, this includes ability to understand multiple products and multiple levels of benefits within each product

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington or Rhode Island Residents Only: The salary range for this is $88,000 – $173,200 per year. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.

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.

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.