Claims Manager - San Juan, PR Job at Optum in San Juan

Join Optum as a Claims Manager in San Juan, PR and lead a team that directly impacts health outcomes by managing provider data and driving operational excellence.

Primary Responsibilities

• Health Care Provider contracting process operations management
• Manage multiple teams and processes with performance expectations and regulatory requirements
• Track, measure and provide feedback to staff on performance
• Serve as an operational leader by creating, implementing, and approving operational changes through documentation and process flows
• Participate or lead development of business strategy
• Interpret, predict, and forecast changes in business operational activities and needs
• Manage teams that generate revenue and savings
• Review the work of others and make course corrections as needed
• Develop innovative approaches and strategies
• Anticipate customer needs and proactively develop solutions to meet them
• Solve complex problems and develop innovative solutions with broad impact on the business
• Provide explanations and information to others on difficult issues, both within the team and other departments
• Develop and lead projects that drive process improvements
• Serve as an operational leader in client implementations
• Track and report business performance using dashboards and scorecards
• Candidate must be highly organized with effective and persuasive communication skills
• Strong analytical, problem solving, and decision‑making skills required; ability to exercise good judgment
• Open to change and new information; ability to adapt behavior and work methods to changing organization and integrate best practices
• Interpersonal skills to influence and spur cultural change, facilitate and enhance performance within a cross‑functional environment
• Ability to gain acceptance for ideas, plans, actions, and then implement flawlessly
• Effective data analysis and interpretation skills
• ENGLISH PROFICIENT ASSESSMENT WILL BE REQUIRED AFTER APPLICATION

Required Qualifications

• 5+ years of experience in the BPO or healthcare industry
• 5+ years of experience utilizing operational metrics, data/analytics, goals/objectives, and dashboards to run, interpret, and drive business performance
• 5+ years of management experience
• Experience with the Microsoft Office Suite
• Proficiency in using advanced functions in Microsoft Excel such as filters, pivot tables, formulas, etc.
• English Proficiency

Preferred Qualifications

• Experience in usage of Six Sigma tools
• Experience in Claims Processing in the healthcare industry

SENIORITY LEVEL

Mid‑Senior level

EMPLOYMENT TYPE

Full‑time

JOB FUNCTION

Finance and Sales

INDUSTRIES

Business Content

LOCATION

San Juan, Puerto Rico

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.
UnitedHealth Group is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment.