Critical Resolution Team – National Remote

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. 

This position is accountable for Group Medicare & Retiree global issue remediation which requires operational fixes for claims, calls, billing, eligibility, appeals, fulfillment, benefit setup and other operational areas. As a member of the Group Retiree Critical Resolution Team you are a single point of contact for Client Management, Group Retiree Operations and Benefit Operations team. This role is accountable for managing the end to end resolution of global issues for all Employer Group clients that may be impacted. This includes identifying impact to the member and client, impact to operational areas, working with operation partners to develop and drive a remediation plan to completion, identify root cause, implementing additional controls as needed, and communicate progress to stakeholders 

This position is full-time (40 hours/week), Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am – 5:00 pm.

We offer weeks of paid training. The hours of the training will be based on schedule or will be discussed on your first day of employment. 

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

  
 
Primary Responsibilities:

• Provide project management skills to focus on our most challenging and complex opportunities 
• Establish credibility with account management teams and demonstrate understanding of client business requirements 
• Candidate needs the ability to diagnose and define root cause issues
• Candidate needs to enjoy and have a proven track record to handle multiple issues at one time

  

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:

• High School Diploma / GED OR equivalent work experience
• Must be 18 years of age OR older
• 2+ years of account management experience (i.e. working with clients, having clients you work with; client interaction)
• 1+ years of project coordination experience and / OR process improvement experience
• Basic knowledge of Operations system and procedures and resolution escalation paths (e.g. workflows, claims processing systems, claims payment methodology)
• Experience with Microsoft Excel (formulas, creating basic pivot tables, v-look up exposure)
• Presently employed within UHC – Client Experience and Operations (CEO)
• Ability to work between the hours of 8:00 am – 5:00 pm from Monday – Friday 

  

Preferred Qualifications:

• 3+ years of experience in Medicare Group Retiree
• Medicare Group Retiree claims, billing, customer service and / OR eligibility experience
• Intermediate level of skill with Microsoft Excel – comfortable with doing functions such as formulas, creating basic pivot tables, exposure to v- look ups, etc  
• Intermediate level of skill with ACET for tracking and reporting

  

Telecommuting Requirements: 

• Ability to keep all company sensitive documents secure (if applicable) 
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy 
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

  

Soft Skills:

• Candidate requires skills to influence, and partner with, operational teams to correct urgent and highly escalated client issues quickly and with quality
• Candidate needs both written and oral communication skills to report to Client Management and Operational leaders on progress and status of issues
• Candidate needs to enjoy and proven track record to handle multiple issues at one time

  

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy