1+ months

Genomics Rule Specialist - Telecommute - 926956

Eden Prairie, MN 55344 Work Remotely
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  • Job Code
    926956

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's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

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The Genomics rule specialist is responsible for researching, defining and implementing clinical and customer requirements and guidelines for the Genomics Payment Manager. The rule specialist will create Edits to be managed centrally within the Optum Content Platform to standardized content management. This position will work closely with the application teams and product in ensuring that requirements are correctly communicated and administered.

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Youll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

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Primary Responsibilities:

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  • Support platform projects
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  • Creating, documenting, and maintaining content
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  • Provide clinical support to potential and current clients
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  • Anticipates customer needs and proactively develops solutions to meet them
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  • Independent decision making related to correct coding and common practice standards
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  • Ability to research source information from CMS and other third-party sources
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  • Researching and creating detailed edits with clinical perspective
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  • Presenting information at clinical meetings or executive meetings
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  • Reviewing, researching and responding to client issues and/or concerns
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  • Working closely with application development to ensure proper claims processing
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  • Provide clear description of problems / issues for medium to high complexity problems
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  • Solve complex problems and develop innovative solutions
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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 experience
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  • 5+ years of experience with Medicaid, Medicare and/or Commercial coverage determination
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  • 5+ years claims processing experience or equivalent experience
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  • Experience creating professional documentation such as writing business requirements, proposal, clinical requirements
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  • 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 a similar UnitedHealth Group-approved symptom screener. 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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  • Excellent 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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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.

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*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.

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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: Genomics Rule Specialist, Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote

Posted: 2021-05-13 Expires: 2021-07-11

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.

Sponsored by:
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Genomics Rule Specialist - Telecommute - 926956

UnitedHealth Group
Eden Prairie, MN 55344

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