UnitedHealthcare · 5 hours ago
Benefit Data Design Configuration Analyst - Surest - National Remote
Dallas, TX
Full-time
Remote
Mid Level
$28.03/hr - $54.95/hr
3+ years exp
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Responsibilities
Execute the build and implementation of benefit plan adjudication rules
Coordinate the integration or conversion of new clients and / or products as needed, often under aggressive timelines
Participate in the development and implementation of an enterprise claim platform, providing subject matter expertise on the system configuration and usability components
Align operational needs with technology requirements
Develop best practices and standard operational procedures for creating and configuring benefit plans
Establish consistency and standardization as it relates to tools and processes (deliverable templates, change management processes, business models, process flows, etc.)
Curate a robust testing suite that is representative of all coverage to better quantify the impact of introducing configuration changes.
Ability to execute testing to ensure the accurate configuration of business requirement
Analyze larger sets claims data to evaluate patterns of billing as it relates to benefit design and configuration
Partner with claim processors, member service and provider service to identify and resolve issues related to the plan configuration
Perform other duties as assigned
Qualification
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Required
High School Diploma / GED OR equivalent work experience
3+ years of business / operations experience in a health plan environment
3+ years of experience with ICD - 10, CPT, HCPCS, revenue codes, and medical terminology
3+ years of experience with using Microsoft Excel (creating, editing, and saving worksheets)
2+ years of experience Analyzing data
1+ years of experience in a healthcare environment with HIPAA, ERISA, and ACA requirements
1+ years of experience with SQL
Experience with the plan build / plan configuration of claim adjudication platform
Experience with commercial health plan design
Experience with data analytics and system mapping of configuration
Experience with project methodology (requirements, design, development, testing, and implementation), inclusive of Scrum and Kanban
Must be 18 years of age OR older
Ability to work any shift between the hours of 8:00 AM - 5:00 PM CST from Monday - Friday including some flexibility based on business need
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.
Preferred
Strong problem - solving skills
Accurate and precise attention to detail
Self - directed with the ability to influence without direct control
Clear, concise, engaging, and effective written and oral communication
Excellent analytical skills with ability to read and understand complex data and make thoughtful, articulate recommendations
Working in an ambiguous and fast - paced environment
Agile, ready to change direction on the fly
Ability to understand complex business processes that cross many functional operational units
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
Benefits
Comprehensive benefits package
Incentive and recognition programs
Equity stock purchase
401k contribution
Company
UnitedHealthcare
UnitedHealthcare helps people live healthier lives by simplifying the health care experience. It is a sub-organization of UnitedHealth Group.
10,001+ employees
H1B Sponsorship
UnitedHealthcare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2023 (35)
2022 (56)
2021 (65)
2020 (61)
Funding
Current Stage
Late StageLeadership Team
Mike Dawson
VP, Product and Innovation at UnitedHealthcare Community & State
R
Rebecca Madsen
Chief Consumer Officer
Recent News
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