UMR, UnitedHealthcare’s third-party administrator (TPA) solution, is the nation’s largest TPA. When you work with UMR, what you do matters. It’s that simple . . . and it’s that rewarding.
In providing consumer – oriented health benefit plans to millions of people; our goal is to create higher quality care, lower costs and greater access to health care. Join us and you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system. Opportunities are endless for your career development and advancement within UMR due to our record-breaking growth.
Regardless of your role at UMR, the support you feel all around you will enable you to do what you do with energy, quality, and confidence. So, take the first step in what is sure to be a fast – paced and highly diversified career.
The Electronic Eligibility Analyst is responsible for the set up and loading of electronic eligibility files for new and existing customers. This position is responsible for the overall electronic eligibility process using various databases, checklists, mapping tables and IT coding. You will research and coordinate the review of electronic eligibility issues including nonstandard requests. This will include auditing electronic eligibility file loads for adherence to quality measures and report standards.
This position is full-time (40-hours/week). Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am – 5:00pm CST, Monday – Friday. It may be necessary, given the business need, to work occasional overtime or weekends.
We offer weeks of on-the-job training. The hours during training will be an 8-hour shift between 8:00am to 5:00pm CST, Monday – Friday. Training will be conducted virtually from your home.
You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
Coordinates the testing and setup of inbound electronic eligibility files in the 834, proprietary, or custom layout
Coordinates and handles outgoing eligibility files for ID cards, pharmacy vendors, 270/271 process, and other vendors
Coordinates calls/meetings with external and internal customers (workgroups and multiple departments) including vendors
Handles IT coding projects and tasks for the Enrollment System and Electronic Eligibility processes.
Helps coordinate IT projects for the Enrollment System coding and updates
Coordinates system updates with IT for all processes and files supported by the Electronic Eligibility Support Team
Helps coordinate the review and analyzation of system, manual, and workflow processes to make the appropriate recommendations for improvement
Handles improvements from recommendation to completion, by handling or working with others on the team creating specifications, test plans, working with the IT area, testing, production review, and implementing new procedures or training materials.
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
Experience with working on process improvement OR enhancement teams
Basic proficiency with using Microsoft Excel (create / edit new documents, sort, filter, basic formulas) and Microsoft Outlook (email)
Ability to work any of our 8-hour shift schedules during our normal business hours of 8:00am – 5:00pm CST, Monday – Friday. It may be necessary, given the business need, to work occasional overtime or weekends
Preferred Qualifications:
1+ years of experience with business analysis
Project coordination experience
Experience with DB2 and / OR Mainframe
Experience in the healthcare insurance industry
Experience with acting as a liaison between business and IT teams
Experience with writing and executing test plans in either a QA or UAT capacity
Knowledge of project methodologies and ability to manage small projects
Experience in working with programming in web – based application and / OR databases
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
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington, Rhode Island, OR Washington, D.C. Residents Only: The hourly range for this is $23.22 – $45.43 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.
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UnitedHealth Group
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