Job Description

UnitedHealth Group 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 about HealthCare. Here, innovation isn't about another gadget, it's about transforming the health care industry. Are you ready to make a difference? Start doing your life's best work.(sm)

We are recruiting for a Program Lead to join our Optum Application Managed Services (AMS) leadership team. The AMS team engages in short- and long-term commitments and partnerships and provides full-service operation to our clients with a proactive approach to business communication, growth and problem resolution. The AMS team partners with health plan clients to become an extension of their organization. The highly seasoned staff is dedicated to managing Prospective Payment Systems (PPS) as well as looking at where PPS fits in the clients Ecosystem. AMS provides services that will help provide long term benefit for the client, not only direct savings and increased revenue but also savings in process, manual effort and other operational areas.

The Program Lead is responsible for ensuring effective implementation projects, staffing resources to client engagements, supporting integration and configuration efforts, service quality, managing projects through go-live and engagement profitability. Additionally, the Program Lead will be responsible for strategic planning, client reporting, NPS improvement, and client by client SLA tracking and adherence.

The Program Lead must maintain a strong working relationship and partnership with the AMS functional team members in order to ensure that the team is aware of client mandates, performance and quality standards, and any changes to the work completed on behalf of the client.

The Program Leader must also have the ability to facilitate meetings and drive effective solutions. The successful Program Lead candidate will have strong communications skills and the ability to liaison between technical and non-technical personnel. The ability to adeptly navigate ever changing priorities is also a key skill of the Program Lead.

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

Primary Responsibilities:

* Support Optum's Prospective Payment Systems (PPS) for AMS clients
* Dedicated Point of Contact for AMS Customers
* Acquire and maintain working knowledge of multiple platform specific knowledge, customer customizations, databases, file systems and architecture that support the application
* Schedule and lead weekly update calls with Customers
* Inventory Management of all projects, issues, changes & defects
* Facilitate and or assist with group meetings via remote collaboration tools (WebEx, MS Teams and telephonically as needed)
* Manage/Drive configuration changes, projects, issues & defects to resolution
* Escalation point for client issues
* Identify opportunities to improve processes, customer engagement, and add client value to maintain and grow the business relationship
* Develop implementation plans to meet go-live goals
* Anticipates customer needs and proactively develops solutions to meet them
* Evaluate system changes for downstream system and/or organizational impacts
* Manage small to large projects from inception through implementation
* Collaborate with Operations and Sales on potential growth or migration opportunities
* Attend Weekly Operations meeting
* Provides input and updates for overall plans: Provide updates for overall plans (risks, completion, level of effort, etc.)
* Develop and maintain Project Plans for project-based deliverables, including strategic initiatives
* Work within client ticketing system to track escalated issues, input new issues or answer issues sent in by other teams
* Work directly with Optum colleagues and customers to determine and document Client PPS payment system methodology education needs.
* Work directly with Optum colleagues and clients to determine and document Client requirements for Optum PPS product training
* Works directly with customers to define other project requirements, provide assistance to answer questions related to project results
* Assist as needed with other PPS AMS projects, including ongoing maintenance or consulting engagements
* Contributor to AMS Community: Ask an Expert, provides feedback for updated content - works with lead/owner of the committee

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:

* Bachelor's Degree OR High School Diploma/GED plus 5 years of equivalent healthcare IT experience
* 5+ years Healthcare reimbursement, claims, implementation, integration or configuration experience
* 5+ years experience analyzing and solving customer problems
* Ability to analyze client business needs to help drive solutions
* Exceptional interpersonal, verbal and written communication skills
* Ability to manage multiple priorities and execute deliverables on time
* Ability to translate highly complex concepts in ways that can be understood by a variety of audiences
* Ability and confidence to interface and communicate at all corporate levels, including executive, business, IT
* Ability to influence senior leadership to adopt new ideas and/or approaches
* Highly motivated and innovative, with the ability to work as part of a high performance team as well as independently
* Proficiency with MS Office applications, including MS-Project
* Demonstrated competency in large-scale organizations within a matrix environment
* 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

Preferred Qualifications:

* 5+ yrs. previous Healthcare Industry experience
* Previous software support experience
* Previous account management experience
* Previous project management experience
* Undergraduate degree
* Basic knowledge and understanding of Prospective Payment Systems - includes DRG, APC, OCE, ESRD, CAH, CMG, RUG, RBRV
* Experience with EasyGroup, Web.Strat and Rate Manager
* Experience pricing Medicare hospital facility claims (inpatient and outpatient)
* Health plan experience in facility contract configuration, claims or IT
* Experience documenting client operational and technical workflow
* Experience configuring and customizing software solutions
* Some SQL experience
* .NET or IIS
* Claims system knowledge - Trizetto Facets, NetworX Pricer, QNXT, Health Edge Health Rules Payer, IKA Claims, Burgess Systems, Epic Tapestry, 3M, RAM HealthSuite, Conduent/HSP MediTrac

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)

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.

*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.

Job Keywords: Healthcare reimbursement, claims, implementation, integration, configuration, telecommute, remote, work from home