Manager, Best Practices Financial Protection Claim Operations - 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 key leadership role will be directly responsible for overseeing critical aspects of the Financial Protection business including claims quality & performance guarantee audits, claims appeals and centralized support of Best Practices. Additionally, this role will help coordinate key compliance, internal audit and external regulatory reviews (e.g., SOC1).

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

Primary Responsibilities:

• Provide direct oversight and facilitation of the claims quality program that informs both internal measures of success supporting operational continuous improvement
• Provides direct oversight and facilitation of the claims performance guarantee review reporting results out monthly to key stakeholders including business leaders, finance partners and the CFO
• Develops and owns measurement of robust quality action plans for the claims organization to ensure continuous improvement in execution is achieved sustainably
• Creates and reports out monthly trends observed in performance via quality and PG measured programs
• Oversees Best Practices specialists that are responsible for key initiatives including standard operating procedure (SOP) drafting, policy & procedure (P&P) documentation updates, maintaining operational business continuity plan and all other duties as defined
• Oversees management of Financial Protection claims appeals process. Dedicated/designated staff on team performing formal appeals process where coordination with key business partners including staff legal and/or corporate compliance may be required
• Acts as primary point of contact for key external regulatory audits including but not limited to SOC1 and state-level audits as well as internal audits as required by LCRA team
• May be required to support in concert with other key teams response to executive complaints as well as Department of Labor (DOL) audits ad hoc

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:

• 3+ years Financial Protection or Group Benefits industry experience
• Experience successfully managing multiple requests, assessing priorities and achieving solutions under deadlines
• Expert level proficiency with MS Excel and Word
• Proven exceptional written and verbal communication skills with ability to communicate to a matrixed leadership team as required
• Proven advanced analytical and information gathering skills with an ability to evaluate and prioritize continuous action plans as required

Preferred Qualifications:

• Experience in audit function
• People leadership experience

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New Jersey, New York, Rhode Island or Washington residents is $88,000 to $173,200 annually. 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.

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.

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.