Senior Business Process Consultant - MST Or CST Remote

Unitedhealth Group Peyton , CO 80831

Posted 2 months ago

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.SM

The Community & State Encounter Program Management team has oversight of complete, timely and accurate encounter (claim) submissions to state customers. This includes working with health plans and states on process improvements, implementing new requirements and analyzing current production results. A Medicaid Encounter Senior Claims Business Process Consultant is a Subject Matter Expert (SME) for one or more states, responsible for establishing a thorough understanding of state encounter requirements and meeting or exceeding those encounter requirements and internal goals by correcting encounters with issues in order to get them accepted by our state customers.

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. If you are located in the MST / CST area, you will have the flexibility to telecommute* as you take on some tough challenges. Training will be conducted virtually from your home.

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

Primary Responsibilities:

  • Gathering, reading and understanding state requirement documentation, then translating into business requirements documents

  • Correcting encounter failures and identifying root causes and remediating the issues demonstrating deeper understanding of upstream and downstream impacts and the bigger picture. Participating in the solution process and monitoring on-going encounters to ensure complete resolution.

  • Gathering and utilizing status against goal metrics (includes contractual requirement measurements, financial completeness reports and financial completeness plans) to identify new issues, prioritizing work, and communicating to leader; communicating program activities and health to health plan leadership, typically more end to end rather than on specific topics only

  • Developing collaborative relationships with internal partners impacting encounters, including health plans.

  • Performing interaction with state partners in order to research issues

  • Hosting or participating in regular meetings with health plans; includes providing clear examples of issue analysis to share with health plans, other functional teams and states to get assistance on resolution, knowing what data is relevant for the audience

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 higher)

  • 4+ years of work experience in the healthcare industry analyzing data or any experience with claims with SQL knowledge

  • Intermediate or higher level of proficiency with Microsoft Word (ability to create, copy, edit, send and save documents) and Microsoft Excel (creating pivot tables, formulas and functions, V-lookups, manipulate large data sets)

  • Must live in a location that can receive a UnitedHealth Group approved high - speed internet connection or leverage an existing high - speed internet service

  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell 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:

  • Bachelor's degree (or higher)

  • Experience with Medicaid Encounters, Medicaid Claims or other related functions, such as Provider Data or Enrollment

  • Healthcare-related background

  • Experience working with PL/SQL within an Oracle Data base

  • Experience working in a matrix-style organization

Soft Skills:

  • Ability to problem solve and research conflicting and / or inaccurate data

  • Ability to communicate analysis, including trends and opportunities, to partners and customers in writing and verbally

  • Ability to work on multiple priorities

UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography-specific trends. At this time, 90% of our non - clinical workforce transitioned to a work at home (remote) status. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us. You can learn more about all we are doing to fight COVID-19 and support impacted communities at:

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 10 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near - obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, Military families and Veterans wherever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.SM

Colorado Residents Only: The salary range for Colorado residents is $64,800 to $116,000. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long-term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

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.

Keywords: Business Process Consultant, Analyst, "MS Project", Project, SQL, Excel, SSIS, PowerShell and/or Alteryx, Python, leader, manager, work at home, work from home, WAH, WFH, remote, telecommute, hiring immediately, #rpo

icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Business Process Owner Senior (Remote Is Available)


Posted 3 weeks ago

VIEW JOBS 5/26/2021 12:00:00 AM 2021-08-24T00:00 Purpose of Job We are currently seeking 2 talented Business Process Owner Senior's for one of the following locations: San Antonio Home Office I, Colorado Springs Campus, Phoenix Campus, Tampa Crosstown, Tampa Campus, Chesapeake, or possibly remote. As business process owner, plans, directs, and coordinates activities for complex processes, including problem definition, evaluation of requirements, design, testing, and implementation of business processes. Understands the process operating objectives, business rules, performance requirements, risks, and controls and interactions between dependent processes to minimize failures, eliminate redundancies, and control process performance necessary to achieve efficient, effective design and execution of the process. Supports alignment of process to overall experience strategy and vision. About USAA USAA knows what it means to serve. We facilitate the financial security of millions of U.S. military members and their families. This singular mission requires a dedication to innovative thinking at every level. We embrace a robust veteran workforce and encourage veterans and veteran spouses to apply. USAA Careers - World Class Benefits (31 seconds) Job Requirements Job Duties * Identifies and manages existing and emerging risks that stem from business activities and the job role. * Ensures risks associated with business activities are effectively identified, measured, monitored, and controlled. * Follows written risk and compliance policies and procedures for business activities. Develops and implements strategic customer specific business process program plans that align with enterprise strategy and influence appropriate roadmap(s). * Applies expert knowledge of the business and leads the alignment and development of business deliverable processes and capabilities to materially change and improve business performance. * Serves as functional expert bringing diverse perspective to leverage multiple ways of thinking while developing end-user focused process solution * Manages the performance of processes by developing control limits, monitoring key performance indicators and informing stakeholders of any deficiencies, improvements, operational risks issues, etc. and drives collaborative efforts to ensure process delivers against requirements * Manages business process risks by using established methodologies and exercising control plans to ensure alignment with business unit specific requirements, process requirements, and business needs. Identifies business unit and business process risks across all activities. * Develops communication plans for customers and internal stakeholders. * Ensures alignment between internal stakeholders and customers across all business process projects and services using proactive communication and engagement strategies. * Utilizes reporting, data, and analytics to measure process and project performance, deliver process operational efficiencies, and inform key stakeholders. Minimum Experience * Bachelor's Degree or 4 additional years (10 Total) of related experience beyond the minimum required may be substituted in lieu of a degree. * 6 years business process execution/knowledge/experience, consulting, and/or process engineering/optimization. * Experience in successfully applying quality management, process improvement, and problem-solving tools and methodologies. * Experience in implementing and sustaining change/improvements (change champion). * Hands on experience with Process Mapping and Modeling and creating and validating process documentation. * Experience in the application of process management standards and policies, and knowledge of applicable regulations and risk management practices. * Demonstrated experience with Lean, Business Process Management, or similar methodology. * Demonstrated experience with utilizing various systems to collect and analyze data. Preferred Experience * Business and auto claims acumen. * Experience formulating strategic operational improvements by synthesizing data from a variety of sources such as Excel and Tableau Compensation: USAA has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market position. The salary range for this position is: $88,200 - $158,900 *(this does not include geographical differential, it may be applied based on your work location). Employees may be eligible for pay incentives based on overall corporate and individual performance or at the discretion of the USAA Board of Directors. * Geographical Differential: Geographic pay differential is additional pay provided to eligible employees working in locations where market pay levels are above the national average. Shift premium will be addressed on an individual-basis for applicable roles that are consistently scheduled for non-core hours. Benefits: At USAA our employees enjoy best-in-class benefits to support their physical, financial, and emotional wellness. These benefits include comprehensive medical, dental and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays plus 16 paid volunteer hours, and various wellness programs. Additionally, our career path planning and continuing education assists employees with their professional goals. Please click on the link below for more details. USAA Total Rewards The above description reflects the details considered necessary to describe the principal functions of the job and should not be construed as a detailed description of all the work requirements that may be performed in the job. At USAA our employees enjoy one of the best benefits packages in the business, including a flexible business casual or casual dress environment, comprehensive medical, dental and vision plans, along with wellness and wealth building programs. Additionally, our career path planning and continuing education will assist you with your professional goals. Relocation assistance is not available for this position. Usaa Peyton CO

Senior Business Process Consultant - MST Or CST Remote

Unitedhealth Group