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UnitedHealth Group

Eligibility Operations Lead

Posted 2 days ago
$24 - $43 per hour
2-5 years experience
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AI Summary

The Eligibility Operations Lead supports operational execution by coordinating work completion, monitoring inventory, and managing aging items. They also troubleshoot escalated issues, facilitate team huddles, and ensure compliance with HIPAA and SOX standards.

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.

You dream of a great career with a great company - where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up. This opportunity is with one of our most exciting business areas: Optum - a growing part of our family of companies that make UnitedHealth Group a Fortune 5 leader.

Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation and Performance.

This position is full time. Employees are required to have flexibility to work any of our shift schedules during our normal business hours of 8:00 am - 5:00 pm local time. 

This will be on the job training. The hours of training have no defined timeline. Training will be remote. 

     

Primary Responsibilities:

  • Supports operational execution across Eligibility Operations by coordinating work completion, tracking inventory commitments, monitoring aging items, validating status reporting, supporting facilitation of leader huddles, and following up on escalated operational risks
  • Escalates operational barriers, resource constraints, and aging inventory risks to leadership for resolution
  • Supports daily execution follow-through
  • Supports leader in coordinating domestic and global team efforts against inventory priorities
  • Troubleshoots escalated issues from internal departments that interrelate with eligibility submission and processing
  • Takes ownership of issues. Thinks through issues and finds solutions. Looks at whole picture, not just individual piece of an issue. Ability to make sound decisions
  • Coordinates follow-up activities related to inventory priorities, operational commitments, and leadership action items
  • Follow through with error issues to resolution with frequent communication for update and resolution status
  • Researches and responds to unique and escalated questions and issues from internal customers
  • May assist in working urgent requests, or working inventory in times of backlog or increased inventory volumes to support team
  • Adhere to all key audit controls and comply with all established standards associated with HIPAA, and SOX
  • Serves as an execution coordinator to help ensure operational priorities are completed timely and accurately
  • Other duties as assigned. Work may be self-prescribed and directed 

     

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
  • 3+ years of experience with progressive responsibility with process improvement initiatives
  • 3+ years of experience working within Microsoft Excel with the ability to filter and sort
  • 2+ years of data analysis experience
  • 1+ years of experience working in a remote capacity with minimal supervision
  • Moderate proficiency with Microsoft Office (Microsoft Word, Microsoft Excel, & Microsoft Outlook) experience
  • Ability to work any of our full time (40 hours / week), 8-hour shift schedules within the operating hours of the department (8:00 am - 5:00 pm local time). 

     

Preferred Qualifications:

  • Facets experience
  • Enrollment / Eligibility experience
  • Health care experience

     

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:

  • Communication, writing skills, time / project management, problem solving, organizational, and analytical skills
  • Ability to solve problems, follow defined processes, make independent decisions, and apply them to problem results
  • Ability to be proactive
  • Ability to apply quality measures / measurements in day-to-day work
  • Experience with issue resolution
  • Ability to work independently with rapid learning curve
  • Computer skills, including working knowledge of MS Windows and mouse and keyboarding skills

     

*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 $24 - $43 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.

       

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