At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. Positions in this function are responsible for providing expertise and customer service support to members, customers, and/or providers. Direct phone-based customer interaction to answer and resolve a wide variety of inquiries. Primary Responsibilities: Answer incoming phone calls from health care providers (i.e. physician offices, clinics) and identify the type of assistance the provider needs (EG. benefit and eligibility, billing and payments, authorizations for treatment, explanation of benefits) Focus on resolving issues on the first call, navigating through complex computer systems to identify the status of the issue and provide appropriate response to caller Deliver information and answer questions in a positive manner to facilitate solid relationships with providers and their staff Complete the documentation necessary to track provider issues and facilitate the reporting of overall trends Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so This role is equally challenging and rewarding. You'll interact with providers with the intent to develop a relationship with them. Within a high volume setting, you'll need to develop knowledge of our various products and multiple levels of benefits within each product in order to best assist our providers/customers. Required Qualifications: Bachelor’s Degree in any specialization (excluding B.E , B. Tech, MCA and pursuing or results awaited in graduation or any backlogs) Extensive work experience within own function Familiarity with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications Demonstrated ability to listen skillfully, collect relevant information, build rapport and respond to customers in a compassionate manner Demonstrated to be skilled in problem solving to quickly assess current state and formulate recommendations Preferred Qualifications: 6+ months of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools Health care experience 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. #NTCLAIMS #NJP
At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. Primary Responsibilities Validate data with administrative source systems (source of truth) Analyze complex datasets Generate actionable insights and recommendations based on data analysis Database Management: Develop and maintain data models, data dictionaries, and other documentation Troubleshoot and resolve database-related issues Data Extraction and Transformation: Support capital project that will, in part, import and transform data from various sources for broker bonus calculations Ensure data integrity and quality through rigorous validation and testing Data Visualization and Reporting: Create visually appealing and informative dashboards and reports Present findings and insights to both technical and non-technical stakeholders in a clear and concise manner Continuous Learning and Improvement: Stay up to date with the latest data analysis techniques and tools Identify opportunities to improve data analysis processes and methodologies Actively participate in knowledge sharing and mentoring within the team Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so Required Qualifications Undergraduate degree or equivalent experience 4+ years Experience as SAS Data Analyst Experience with relational database management systems (e.g., MySQL, Oracle, SQL Server) Experience with statistical analysis Familiarity with data visualization tools (e.g., Tableau, Power BI) Proven excellent problem-solving and critical thinking skills Proven solid communication and presentation skills to effectively convey complex data analysis findings to both technical and non-technical stakeholders Proven ability to work independently and collaboratively in a fast-paced, deadline-driven environment Proven detail-oriented with a focus on accuracy and data integrity 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. #NTRQ Show more Show less
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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. Primary Responsibilities Be able to handle escalated calls/meetings directly with Customers, Brokers, etc. and provides resolution at the earliest Drives Basic Hygiene on the operations floor and build culture for the same Assist the New Hires & Tenured staff in meeting the performance standards of the process Build systems, controls to ensure no escalations and is prompt in responding to escalations Provide coaching and feedback to team members to enable them to improve their performance and focus on their career pathing and advancement within the organization Motivate and engages team members and maintain attrition thresholds as per organization guidelines Provide inputs to leadership on process gaps that exist Ensure compliance with internal policies and procedures, external regulations and information security standards Be sensitive and aware of the Organizational priorities towards Change & Innovation and Cost Optimization Driving Cost Reduction agenda in the processes with Automation Opportunities, Productivity Enhancement Opportunities and Cross utilization of resources Takes initiative to understand the process and keeps himself updated on the important changes in the business and the Healthcare industry Maintain data accuracy for the tasks assigned and respond within timelines defined/agreed Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so Required Qualifications Graduate 5+ years of experience in US Healthcare only 3+ years of experience as a Team Lead or Assistant Manager on Paper Experience in handling a Team of 15 to 20 members International Voice exposure Exposure to all the facets of Operation Management Exposure to People Management, Performance & Client Management Ability to use Microsoft Office Products (Excel and Access) Proven ability to work independently with minimal direction and is very high on execution and adherence to timelines ,
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference Join us to start Caring. Connecting. Growing together. As a Member Issue Resolution Analyst, you will be responsible for performing complex reconciliations for members claim issues across 2-4 processing entities. This will require a financial and analytical mindset to be able to identify, remediate, and prevent issues affecting our members in delegated arrangements. The Member Issue Resolution Analyst will be responsible for reducing the number of member inquiries by working with entities to improve accuracy, decrease abrasion, and improve the overall experience of our customers and constituents. Primary Responsibilities Review and resolve complex cases with an end to end mindset to prevent issues or inquiries from recurring. Scope open inventory for like issues for cases worked to group and resolve batches. Demonstrate a knowledge of end-to-end processes of multiple different types of capitated and delegated arrangements within the Value Based Care Model Identify and articulate trends occurring within a risk entity or across multiple risk entities within claims processing and cost share application Identify and articulate trends with our assigned delegates with the Sr. Issue Resolution Analyst and partner to work towards shift left initiatives Partner and collaborate internally and with Risk Entities to correct claims processing and cost share application errors to prevent recurring issues. Actively participate in meetings with cross functional areas aligned by risk entities to share findings Identify and communicate opportunities for improving issue resolution processes, including automation. Clearly document findings and solutions for trended issues after performing root cause analysis Ability to work across lines of business, claims platforms and on service provider/Delegate issues as needed Perform reconciliation of member inquiry cases, respond to the specific issue of the inquiry, as well as review for and resolve other issues that may be present for the member, outside of the inquiry Support and communicate with the Sr. Issue Resolution Analyst assigned to your Delegate. Perform root cause and trend analysis of issues by assigned Delegate. Clearly document findings and solutions to prevent future issues Communicate effectively (both written and verbal) with business partners Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regard to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so Required Qualifications Degree or equivalent data science, analysis, mathematics experience Experience supporting operational teams performance with reports and analytics Experience using Word (creating templates/documents), PowerPoint (creation and presentation), Teams, and SharePoint (document access/storage, sharing, List development and management) Basic understanding of reporting using Business Insights tools including Tableau and PowerBI Expertise in Excel (data entry, sorting/filtering) and VBA Proven ability to work across lines of business, claims platforms and on service provider/Delegate issues as needed Proven solid communication skills including oral, written, and organizational skills 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.
With every role in the company, each position has a requirement for building quality into every output. The Technology Quality Function is reserved for those positions where Quality is the primary objective of the work delivered. Technology Quality roles will cover all primary quality activity across all technology functions that ensure we deliver high quality products and services. These roles include, but are not limited to, strategy, planning, standards, process, policy, tools, engineering, assurance, management, metrics, research and development, automation, data preparation, maintenance, new development, operations and delivery. Analyzes and investigates. Provides explanations and interpretations within area of expertise. Essential 3 years' experience in a Technical testing role Must be able to do basic programming in C# or a similar OOP language such as C++, Java. A passion for quality and a tendency to ensure that the i's are dotted and the t's are crossed. A questioning mind, never accepting anything at face value. An 'under the hood' approach to understanding systems and a need to get down to the nuts and bolts of how things work. Basic knowledge of scripting technologies such as PowerShell or Python. Knowledge of software testing methodology (Various techniques, frameworks, etc.) Exposure to some aspects/phases of automation including GUI, integration testing, and performance/load testing. Experience with defining test plans and test cases Experience working closely with a team of software engineers and product owners. Exposure to working with Product Owners and SMEs to define user story examples/acceptance criteria and exposure to Gherkin using tools like SpecFlow and Fitnesse. Some experience in understanding and testing complex enterprise systems architecture. Basic MSSQL skills and some understanding of complex XML structures. Good experience defining lightweight, high value test plans and tests. Experience working closely with a team of software engineers and product owners. Superb communication skills both written and verbal. Desirable ISTQB Foundation in Testing with Agile Tester extension or similar qualification. Some experience working with geographically distributed team members. Exposure to Microsoft Visual Studio, .NET Framework (v2.0 to v4.5) and C#. Degree in a Computing related subject such as Computer Science, Software Engineering etc. Previous experience in the Healthcare domain. see recruiter Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 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 where ever 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 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.
With every role in the company, each position has a requirement for building quality into every output. The Technology Quality Function is reserved for those positions where Quality is the primary objective of the work delivered. Technology Quality roles will cover all primary quality activity across all technology functions that ensure we deliver high quality products and services. These roles include, but are not limited to, strategy, planning, standards, process, policy, tools, engineering, assurance, management, metrics, research and development, automation, data preparation, maintenance, new development, operations and delivery. Analyzes and investigates. Provides explanations and interpretations within area of expertise. Essential 3 years experience in a Technical testing role Must be able to do basic programming in C# or a similar OOP language such as C++, Java. A passion for quality and a tendency to ensure that the i's are dotted and the t's are crossed. A questioning mind, never accepting anything at face value. An under the hood approach to understanding systems and a need to get down to the nuts and bolts of how things work. Basic knowledge of scripting technologies such as PowerShell or Python. Knowledge of software testing methodology (Various techniques, frameworks, etc.) Exposure to some aspects/phases of automation including GUI, integration testing, and performance/load testing. Experience with defining test plans and test cases Experience working closely with a team of software engineers and product owners. Exposure to working with Product Owners and SMEs to define user story examples/acceptance criteria and exposure to Gherkin using tools like SpecFlow and Fitnesse. Some experience in understanding and testing complex enterprise systems architecture. Basic MSSQL skills and some understanding of complex XML structures. Good experience defining lightweight, high value test plans and tests. Experience working closely with a team of software engineers and product owners. Superb communication skills both written and verbal. Desirable ISTQB Foundation in Testing with Agile Tester extension or similar qualification. Some experience working with geographically distributed team members. Exposure to Microsoft Visual Studio, .NET Framework (v2.0 to v4.5) and C#. Degree in a Computing related subject such as Computer Science, Software Engineering etc. Previous experience in the Healthcare domain. see recruiter Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 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 where ever 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 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.
With every role in the company, each position has a requirement for building quality into every output. The Technology Quality Function is reserved for those positions where Quality is the primary objective of the work delivered. Technology Quality roles will cover all primary quality activity across all technology functions that ensure we deliver high quality products and services. These roles include, but are not limited to, strategy, planning, standards, process, policy, tools, engineering, assurance, management, metrics, research and development, automation, data preparation, maintenance, new development, operations and delivery. Analyzes and investigates. Provides explanations and interpretations within area of expertise. Essential 3 years experience in a Technical testing role Must be able to do basic programming in C# or a similar OOP language such as C++, Java. A passion for quality and a tendency to ensure that the i's are dotted and the t's are crossed. A questioning mind, never accepting anything at face value. An under the hood approach to understanding systems and a need to get down to the nuts and bolts of how things work. Basic knowledge of scripting technologies such as PowerShell or Python. Knowledge of software testing methodology (Various techniques, frameworks, etc.) Exposure to some aspects/phases of automation including GUI, integration testing, and performance/load testing. Experience with defining test plans and test cases Experience working closely with a team of software engineers and product owners. Exposure to working with Product Owners and SMEs to define user story examples/acceptance criteria and exposure to Gherkin using tools like SpecFlow and Fitnesse. Some experience in understanding and testing complex enterprise systems architecture. Basic MSSQL skills and some understanding of complex XML structures. Good experience defining lightweight, high value test plans and tests. Experience working closely with a team of software engineers and product owners. Superb communication skills both written and verbal. Desirable ISTQB Foundation in Testing with Agile Tester extension or similar qualification. Some experience working with geographically distributed team members. Exposure to Microsoft Visual Studio, .NET Framework (v2.0 to v4.5) and C#. Degree in a Computing related subject such as Computer Science, Software Engineering etc. Previous experience in the Healthcare domain. see recruiter Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 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 where ever 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 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.