Director, Claims Operations - Telecommute

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Posted 5 days ago United States $110k - 211k (US Dollars)
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Job Description

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

Responsible for leading execution change management, claims strategies, leader development and technology adoption. Drives execution of operational risk management, day to day clams oversight including driving contract commitments and quality improvements, enhancing policies and procedures, and working to implement new claims process requirements based on customer growth.

You'll enjoy the flexibility to telecommute* from anywhere within United States as you take on some tough challenges.

Primary Responsibilities:

  • Manage and be accountable for professional employees and/or supervisors
  • Coordinate and supervise daily / weekly / monthly activities of team members
  • Set priorities for the team to ensure task completion and performance goals are met
  • Coordinate work activities with other supervisors, managers, departments, etc.
  • Identify and resolve operational problems using defined processes, expertise, and judgment
  • Provide coaching, feedback, and annual performance reviews as well as formal corrective action
  • Takes major role in setting direction and participating in or developing new programs
  • Sets team direction, resolves problems, and provides mentoring and guidance to team supervisors and team members and other staff
  • Ensures team meets established performance metrics, outcomes, and defined customer performance guarantees
  • Adapts departmental plans and priorities to address business and operational challenges as documented within reports and data
  • Influences or provides input to forecasting and planning activities
  • Tracking and trending data, reporting team key performance metrics, measuring outcomes, and implementing process improvement initiatives
  • Product, service, or process decisions are most likely to impact multiple groups of employees and/or customers (internal or external)
  • Work to establish a regular meeting schedules and check-ins with Implementation team members

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:

  • 10+ years of progressive leadership experience including leading claims operations
  • 10+ years of claims center experience (Including experience with Claims Throughput, Staffing Models, Oversight Metrics to measure Efficiency, Quality & Turnaround times)
  • Experience implementing improvement initiatives, integrating the voice of internal and external constituents
  • Health care industry experience
  • Experience working with pricing models and having workable knowledge about developing Cost Benefit Analysis
  • Customer / consultant relationship management and collaboration skills
  • Willing and able to travel up to 10%
  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the Protect Well mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Preferred Qualifications:

  • Call center or additional operational experience in a healthcare environment
  • Federal Claims and/or Contracting experience
  • Referral Management and Appeals & Grievances experience
  • Six Sigma expertise and working with Agile delivery model
  • Demonstrable operational skills (accountable for risk from ideation to execution)
  • Proven ability to drive a cross-functional team that produces value
  • Proven ability to foster and manage senior - level relationships in a highly matrixed environment
  • Ability to influence with and without direct management / authority
  • Exceptional communication skills both written and oral

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

Colorado Residents Only: The salary range for Colorado residents is $110,200 to $211,700. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.

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

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.

Job keywords: Director, Claims, Claims Operations, Healthcare, Leadership, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, WAH, Eden Prairie, MN, Minnesota