17 days old

Claim Operations Manager - Secaucus, NJ - 922640

Secaucus, NJ 07094
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  • Job Code
    922640

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 is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

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On the one hand, no industry is moving faster than health care. On the other, no organization is better positioned to lead health care forward than Optum and UnitedHealth Group. Thats what makes this opportunity so applause worthy. We have hundreds of business verticals across our matrixed organizations that are bringing thousands of new ideas, services and products to the marketplace every year. Our goal is simple. Use data and technology to help drive change and make the health care system work better for everyone. When you join us as Manager Claim Operations, you'll be engaged in a complex business model that is highly adaptable to build solutions that meet their customer needs in a competitive and effective way.

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Primary Responsibilities:

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  • Provide leadership to and is accountable for the claim operation performance and direction through Supervisors and front-line staff
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  • Scope of responsibility across multiple markets, Health Plan payors and products
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  • Leadership of Claims processing and data entry for multiple markets and Health Plan payors and products (Medicare, Medicaid, Commercial)
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  • Partners with global adjudication team leadership and staff to achieve business goals and performance MBOs
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  • Sets team direction in order to meet division quality, time service and productivity goals
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  • Coaches, mentors and provides guidance to multiple levels of staff, including supervisors of frontline teams
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  • Establishes and leads quality action plans to improve team quality performance.
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  • Daily monitoring of work queues and workflow
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  • Collaborates with Workforce Management on staffing needs and trends, and manages new hire process, from requests for approval, through on-boarding
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  • Leads team meetings on a weekly or monthly basis, or other frequency, and attends and actively participates in other meetings as needed
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  • Administers quarterly compensation plan for production employees
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  • Works with the Training department on new topics, cross training and on-the-job refresher training needs
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  • Complete quarterly updates and yearly Business Continuity Process exercise
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This role will challenge your ability to work in a complex environment of claim processing operations where we are expanding capabilities rapidly to meet customer requirements and grow the business. Youll need flexibility, agility and the ability to adapt to change while maintaining strong relationships with stakeholders in a highly cross-matrixed environment.

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Youll 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.

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Required Qualifications:

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  • Undergraduate degree or equivalent work experience in health-related or insurance-related operations
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  • 2+ years of leadership experience in health-related or insurance-related operations
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  • Demonstrated Project Management/Process Improvement experience and results
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  • Ability to work independently without direct supervision
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  • You will be asked to perform this role in an office setting or other company location
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  • Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained
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Preferred Qualifications:

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  • Managerial experience: leader of leaders
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  • Experience leading claim processing teams
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  • Experience working in partnership with global teams
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  • Experience with Facets claim adjudication platform
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  • Experience in claim operations: Medicare, Medicaid, Commercial serving multiple Health Plan payors
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  • Knowledge of Optum claim processing systems, policies and procedures
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  • Strong organizational and time management skills, attention to detail and problem-solving, good written and verbal communication skills
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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)

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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.

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UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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Job Keywords: Claim Operations, Facets, Claim Manager, Manager, Leadership, Business Operations, Healthcare, Optum, Secaucus, NJ, New Jersey

Posted: 2021-04-01 Expires: 2021-05-01

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Claim Operations Manager - Secaucus, NJ - 922640

UnitedHealth Group
Secaucus, NJ 07094

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