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Job Details

UnitedHealth Group

Associate Director Claims Business Process - Telecommute (109757445)

Business Development




Minnetonka, Minnesota, United States

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)

An Associate Director Claims Business Process working on the EPM team ensures we meet or exceed Medicaid Encounter requirements and internal goals for their states. Time is split between both detailed encounter analysis work and the work of leading a team, including developing the team, identifying risks to goals and commitments, and escalating those to break down barriers and drive resolution. Communication is a key focus at this position and includes modifying to suit the audience. This position is empowered to make independent business decisions.

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

Primary Responsibilities:

  • Managing overall business direction for a team with the mission of achieving encounter contractual compliance and internal business goals
  • Managing direct reports, setting training and mentoring direction for team and providing training and mentoring to individuals
  • Identifying risks to compliance and/or internal goal achievement and escalating effectively to break down barriers and drive resolution, adapting business plans and priorities as needed to address business and operational challenges
  • Owning end-to-end business process activities, creating, controlling, and improving business processes
  • Developing and demonstrating advanced encounter knowledge across three or more states, advising team on encounter bypasses and rejects and encounter issue root causes as needed
  • Managing the implementation of encounter requirements and ensuring expected results are achieved
  • Managing operational participation in encounter technology projects, prioritizing, and making business decisions
  • Managing encounter corrections and partnering with Information Technology team on these
  • Owning collaborative relationships with internal partners impacting encounters, with health plan customers and with state customers
  • Utilizing deep communication and storytelling skills and managing relationships to achieve desired outcomes; includes summarizing for leaders
  • Utilizing status reporting to identify new issues, for prioritizing work, and for communicating status to health plan leadership
  • Leading or participating in regular meetings with health plans; includes providing clear issue analysis with examples to get assistance on resolution from internal partners or the state, knowing which data is relevant for the audience

You’ll 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.

Required Qualifications:

  • 5+ years of managing stakeholders from multiple matrix partners (e.g., claims, provider, IT, and Health Plan leaders)
  • Experience leading resources through changing priorities and ambiguity
  • Experience with continuous process evaluation and improvement
  • Intermediate level of proficiency working with MS Excel (creating pivot tables, formulas and functions, V-lookups, manipulating large data sets)

Preferred Qualifications:

  • BA/BS
  • Healthcare operations / health insurance experience
  • Experience with Medicaid Encounters and/or Medicaid Claims
  • Experience leading and developing team, including 1+ year leading direct reports
  • Experience analyzing data, including experience working with and analyzing large quantities of data
  • Working knowledge of relational databases and experience using at least one data query language (e.g., PL / SQL)
  • Ability to communicate effectively across internal functional leaders and teams and with external stakeholders
  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 5 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)

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $97,300 to $176,900. The salary range for Connecticut / Nevada residents is $97,300 to $176,900. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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.