23 days old

Grievances & Appeals Manager - UHC C & S - Telecommute in Oklahoma City or Greater Oklahoma City Area, OK - 920774

Oklahoma City, OK 73102 Work Remotely
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  • Job Code
    920774

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

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Transforming health care for everyone takes a huge effort. But we never said major impact was easy. At UnitedHealthcare, we are working to create a system that is connected, aligned and more affordable for all involved. One that delivers high quality care, responsive to the needs of each person and the communities in which they live.

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As part of the UnitedHealth Group family of businesses, we have the support and resources of a Fortune 7 industry leader to do so.

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As the Grievances & Appeals Manager, you'll be responsible for managing all aspects of the Grievance and Appeal Process for the Health Plan. Responsible for fully understanding the State of Oklahomas processes and regulations. Will be handling high volume Grievances & Appeals at the start of enrollment. This role requires timeliness in responding to up to Leadership and providing data so we can work with State Partners in identifying trends and issues and provide solutions to the State Partners.

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If you are located in Oklahoma City or greater Oklahoma City area, OK, you will have the flexibility to telecommute* as you take on some tough challenges. You must be able to come into the office as needed.

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Primary Responsibilities:

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  • Coordinating, managing and is accountable for the daily activities of Grievances & Appeals function
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  • Staff management
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  • Provide recommendations to leadership for improving processes
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  • Manage work completed within compliance timeframes
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  • Lead team meetings
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  • Strong communication skills and the ability to multitask is key to the success of this position
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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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  • Bachelors Degree or equivalent professional experience
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  • 3+ years of Grievances & Appeals experience
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  • 2+ years of staff management experience
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  • Experience in pulling, running and understanding data
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  • Intermediate computer skills to include Microsoft Office
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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 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
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Preferred Qualifications:

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  • Experience working with claims
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  • Call center or phone queue experience
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  • Experience working in a managed care environment
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  • Experience in preparing and giving presentations
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"Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low-income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)

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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: Grievances & Appeals Manager, Grievances, Appeals, UHC, C&S, Staff Management, Telecommute, Telecommuting, Telecommuter, Work From Home, Work At Home, Remote, Oklahoma City, Greater Oklahoma City, Midwest City, Norman, Edmond, Moore, Shawnee, OK, Oklahoma

Posted: 2021-03-23 Expires: 2021-04-22

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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Grievances & Appeals Manager - UHC C & S - Telecommute in Oklahoma City or Greater Oklahoma City Area, OK - 920774

UnitedHealth Group
Oklahoma City, OK 73102

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