UnitedHealth Group is hiring: Claims Manager - San Juan, PR in San Juan

Overview

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.

It's a big step forward when you realize that you've earned the trust to lead a team. Now, let's determine just how big that step can be. Take on this managerial role with UnitedHealth Group and you'll be part of a team that's reshaping how health care works for millions. We're driving ever higher levels of sophistication in how provider networks are composed and perform. Join us and you'll play a key role in directing the management of data and databases of physicians and specialists who are part of our provider networks. You'll join a team of incredibly talented technology and business professionals where you'll find discover the resources, backing and opportunities that you'd expect from a Fortune 5 leader.

Responsibilities

• Health Care Provider contracting process operations management
• Manages multiple teams and processes each with their own set of performance expectations and regulatory requirements
• Tracks, measures and provides feedback to staff on performance
• Serves as an operational leader by creating, implementing and approving operational changes through documentation and process flows
• Participates or leads development of business strategy
• Ability to interpret, predict and forecast changes in business operational activities and needs
• Manages teams that generate revenue and savings
• Reviews the work of others and make course corrections as needed
• Develops innovative approaches and strategies
• Anticipates customer needs and proactively develop solutions to meet them
• Solves complex problems and develops innovative solutions with broad impact on the business
• Provides explanations and information to others on difficult issues, both within the team and other departments
• Develops and leads projects that drive process improvements
• Serves as an operational leader in client implementations
• Tracks and reports 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 proficiency will be assessed after application.

Qualifications

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 Qualification:

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

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyoneof every race, gender, sexuality, age, location and incomedeserves 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.

#J-18808-Ljbffr In Summary: 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 . En Español: Overview Optum es una organización global que ofrece atención, ayudada por la tecnología para ayudar a millones de personas a vivir vidas más saludables. El trabajo que haga con nuestro equipo mejorará directamente los resultados de salud al conectar a las personas con el cuidado, beneficios farmacéuticos, datos y recursos que necesitan para sentirse lo mejor posible. Aquí encontrará una cultura guiada por inclusión, compañeros talentosos, beneficios integrales y oportunidades de desarrollo profesional. Ven a hacer un impacto en las comunidades que servimos mientras nos ayudan a avanzar en la optimización de la salud a escala mundial. Únete a nosotros para comenzar Caring. Conectándose. Crecer. Es un gran paso cuando te das cuenta de que has ganado la confianza para liderar un equipo. Ahora, vamos a determinar qué tan grande puede ser ese paso. Tome este papel gerencial con los profesionales del Grupo United Health y usted será parte de un equipo que forma un proveedor de datos de atención médica que trabaja junto a nuestros proveedores de servicios especializados. Responsabilidades Proveedor de atención médica gestión contractual de operaciones del proceso Maneja múltiples equipos y procesos cada uno con su propio conjunto de expectativas de rendimiento y requisitos regulatorios Rastrear, medir y proporcionar retroalimentación al personal sobre el desempeño Sirve como líder operativo mediante la creación, implementación y aprobación de cambios operacionales a través de documentación y flujos de procesos Participa o lidera el desarrollo de una estrategia empresarial Capacidad para interpretar, predecir y pronosticar los cambios en las actividades operativas y necesidades empresariales Geren equipos que generan ingresos y ahorros Revise el trabajo de otros y realiza correcciones de curso según sea necesario Desarrolla enfoques e estrategias innovadoras Anticipa las necesidades de los clientes y desarrolla proactivamente soluciones para satisfacerlas Resolve problemas complejos y estimula soluciones innovadoras con impacto amplio en el negocio Proporciona explicaciones e información a otras personas sobre cuestiones difíciles, tanto las acciones interpersonales y otros Desarrollará y llevará a cabo proyectos que mejora las prácticas operativas dentro de los departamentos de trabajo Los mejores conocimientos necesarios para lograr un mejor funcionamiento y mejorar los resultados deben ser aplicados. Calificaciones Requeridas Qualificaciones: 5+ años de experiencia en la industria BPO o sanitaria Experiencia en el procesamiento de reclamos en el sector sanitario En UnitedHealth Group, nuestra misión es ayudar a las personas a vivir vidas más saludables y hacer que el sistema de salud funcione mejor para todos. Creemos que todo el mundo de toda raza, género, sexualidad, edad y ubicación merece la oportunidad de vivir su vida más saludable. Sin embargo, hoy todavía hay demasiados obstáculos que reflejan desproporcionadamente los ingresos e incidencias de nuestros grupos de atención médica que están comprometidos con mejorar nuestro entorno y nuestras necesidades médicas. UnitedHealth Group es un empleador de Equal Employment Opportunity bajo la ley aplicable y los solicitantes calificados recibirán una consideración para el empleo sin tener en cuenta su raza, origen nacional, religión, edad, color, sexo, orientación sexual, identidad de género, discapacidad o estatus de veterano protegido, u otra característica protegida por leyes locales, estatales o federales, reglas o regulaciones.