Employer and Individual Reimbursement Policy Manager ?????? US Telecommut

United Health Group
Sep 22, 2016
Sep 25, 2016
Employer Type
Direct Employer
Employment Type
Full Time
Position Description:

You'll join a high caliber teamwhere you're assisting, educating, problem-solving and resolving tenuoussituations to the best possible outcomes. Bring your people skills, emotionalstrength and attention to detail. In return we offer the latest tools and mostintensive training program in the industry. Get ready to start doing yourlife's best work.

This position will be a part of avirtual team responsible for developing and maintaining Fraud, Waste andAbuse reimbursement policy editing tosupport the Employer & Individual businesssegment. This position will work with other SME's to identify trends, determineregulatory opportunities and constraints and make recommendations for new andrevised reimbursement policies.

Accountability to identify andpursue automated editing solutions while ensuring data integrity, data securityand process optimization. Responsible for driving affordabilityopportunities through CMS methodology research with urgency.

Primary Responsibilities:

* Company thought leader
* Functional SME
* Broad business approach
* Resource to senior leadership
* Develops pioneering approaches to emerging industry trends

Required Qualifications:

* High School Diploma or GED
* CPC Certification
* 5+ years experience in commercial reimbursement policy
* Experience researching potential policy sourcing avenues including CMS, CPT??, Specialty Societies, and others as applicable
* Working knowledge of the UNET claims platform
* Intermediate proficiency with Microsoft Excel and Word (Excel will be part of work; able to pivot tables, data files, write simply formulas, subtotals, understand and manipulate data. With Word, involves reviewing and tracking changes, add commentaries, work with documents that are heavily formatted and tables embedded in the document).

Preferred Qualifications:

* Undergraduate degree (or higher)
* Experience in project management
* Knowledge with Fraud, Waste and Abuse recovery concepts
* Working knowledge of professional and facility claim reimbursement
* Experience writing business requirements
* 2+ years of experience with clinical editing tools in support of reimbursements
* Proficiency with One Note and PowerPoint
* Experience designing and/or maintaining iCES editing to support reimbursements
* Experience managing multiple projects and affordability initiatives simultaneously
* Experience with interpreting financial reports and manipulating data
* Experience in policy writing (ex: reimbursements, but not limited to)

Soft Skills:

* Excellent business writing skills for provider communications and leadership summarization
* Ability to build cohesive relationships, working across departments
* Exceptional organizational skills
* Excellent presentation skills with the ability to clearly articulate information
* Exceptional customer service skills with the ability to interpret customer needs
* Exceptional innovative thinking skills
* Ability to identify business technical solutions for reimbursements needs
* Exceptional leadership, negotiation and influencing skills

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 14organization that's serving more than 85 million people already and buildingthe industry's singular reputation for bold ideas and impeccable execution.Now, add your energy, your passion for excellence, your near-obsession withdriving change for the better. Get the picture? UnitedHealthcare is servingemployers and individuals, states and communities, military families andveterans where ever they're found across the globe. We bring them the resourcesof an industry leader and a commitment to improve their lives that's second tonone. This is no small opportunity. It's where you can do your life's bestwork.

Diversity creates a healthier atmosphere: UnitedHealthGroup is an Equal Employment Opportunity/Affirmative Action employer and allqualified applicants will receive consideration for employment without regardto race, color, religion, sex, age, national origin, protected veteran status,disability status, sexual orientation, gender identity or expression, maritalstatus, 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.

BACH_a33d1a tenuoussituations

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