Claims Manager - San Juan, PR at UnitedHealth Group Canada

, Puerto Rico, United States -

Full Time

Start Date

Immediate

Expiry Date

08 Jan, 26

Salary

0.0

Posted On

10 Oct, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Claims Management, Data Analysis, Operational Leadership, Process Improvement, Team Management, Healthcare Provider Contracting, Performance Tracking, Business Strategy Development, Problem Solving, Communication Skills, Interpersonal Skills, Adaptability, Six Sigma, Microsoft Excel, Analytical Skills, Decision Making

Industry

Hospitals and Health Care

Description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. It's a big step forward when you realize that you've earned the trust to lead a team. Now, let's determine just how big that step can be. Take on this managerial role with UnitedHealth Group and you'll be part of a team that's reshaping how health care works for millions. We're driving ever higher levels of sophistication in how provider networks are composed and perform. Join us and you'll play a key role in directing the management of data and databases of physicians and specialists who are part of our provider networks. You'll join a team of incredibly talented technology and business professionals where you'll find discover the resources, backing and opportunities that you'd expect from a Fortune 5 leader. Primary Responsibilities: Health Care Provider contracting process operations management Manages multiple teams and processes each with their own set of performance expectations and regulatory requirements Tracks, measures and provides feedback to staff on performance Serves as an operational leader by creating, implementing and approving operational changes through documentation and process flows Participates or leads development of business strategy Ability to interpret, predict and forecast changes in business operational activities and needs Manages teams that generate revenue and savings Reviews the work of others and make course corrections as needed Develops innovative approaches and strategies Anticipates customer needs and proactively develop solutions to meet them Solves complex problems and develops innovative solutions with broad impact on the business Provides explanations and information to others on difficult issues, both within the team and other departments Develops and leads projects that drive process improvements Serves as an operational leader in client implementations Tracks and reports business performance using dashboards and scorecards Candidate must be highly organized with effective and persuasive communication skills Strong analytical, problem solving and decision-making skills required; ability to exercise good judgment Open to change and new information; ability to adapt behavior and work methods to changing organization and integrate best practices Interpersonal skills to influence and spur cultural change, facilitate and enhance performance within a cross-functional environment Ability to gain acceptance for ideas, plans, actions and then implement flawlessly Effective data analysis and interpretation skills *** ENGLISH PROFICIENT ASSESSMENT WILL BE REQUIRED AFTER APPLICATION *** 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 experience in the BPO or healthcare industry 5+ years of experience utilizing operational metrics, data/analytics, goals/objectives, and dashboards to run, interpret, and drive business performance 5+ years of management experience Experience with the Microsoft Office Suite Proficiency in using advanced functions in Microsoft Excel such as filters, pivot tables, formulas, etc. English Proficiency Preferred Qualification: Experience in usage of Six Sigma tools Experience in Claims Processing in the healthcare industry At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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Responsibilities

The Claims Manager will oversee the healthcare provider contracting process and manage multiple teams to ensure performance expectations are met. This role involves tracking business performance, developing innovative strategies, and leading projects that drive process improvements.