Government Operations Specialist

UnitedHealth Group - Minnetonka, MN

Full-time
UnitedHealthcare Employer & Individual is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.When you work with UnitedHealthcare Employer & Individual, what you do matters. It's that simple...and it's that challenging. 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.

Regardless of your role at UnitedHealthcare Employer & Individual, the support you feel all around you will enable you to do what you do with energy, integrity, and confidence. So take the first step in what is sure to be a fast paced and highly diversified career. This is your life's best work.(sm)

UnitedHealthcare’s Employer and Individual Specialty Benefits organization is seeking a Government Operations Specialist. In this role, you will grow your career by influencing growth and the processes needed to support our growth. This is the opportunity for you to build out new protocols and processes that– to build something that will continue to help grow network and streamline processes.

Primary Responsibilities:
Develop and oversee process for new business implementations and dental product changes
Handles assigned operational system change projects involving benefit, claims, provider, reporting or clinical work streams
Conducts initial quality assurance check of any outputs provided by vendor or internal operations teams to ensure output meets the criteria initially provided by UHC Dental Account Manager.
Requests changes or corrections, if necessary, prior to request final quality assurance check from UHC Dental Account Manager.
Requests final quality assurance testing by UHC Dental Account Manager after initial quality assurance testing is completed and approved.
Reviews new cases and service request tickets for understanding of the intention of the request
Develops details of the cases/tickets for missing information, to ask clarifying questions, and to understand next steps.
Continuously monitors tickets for awareness of next steps, requests for clarifications, etc.
Proactively addresses operational process issues.
Serves as SME for key vendor processes and business requirements
Integrated status reporting, communication, escalation and meeting management
Manages key data exchanges process in conjunction with SME

Encounter Data
Eligibility
Reviews data schema
Ad hoc data exchanges

Develop and improve existing processes and tools
Share best practices with other workgroup members.
Mentor new hires
Provide ad hoc support to internal customers and team
Generate supporting materials for clients including implementation guides, system reference documents, and standard customer correspondence.
Research and resolve operational complex inquiries/issues requiring expert job knowledge and comprehensive understanding of downstream impacts.
Project manage routine/smaller-scale operations and implementation projects
Consistently track metrics and goals.
Facilitates execution with vendor (Skygen)
Provides status updates to management team. Including operations opportunities, project ideas, and issue resolution
Prioritizes service requests and ensures timely delivery of operational changes
Facilitates business requirement discovery between functional owners and solution provider
Creates and maintains an active library of Standard Operating Procedures (SOPs), process documentation, internal and external contact and escalation points
Creates and maintains knowledge base library items as assigned
Responds to email or other modes of inquiry on operational questions or follow-up issues in a timely manner (1 business day).
Works with internal partners for escalations and high volume ticket resolution
May manage staff directly and indirectly as assigned
Review/create or maintain workflows to ensure they are up to date and operationally efficient across teams
Seek feedback from customers (internal and external) to determine success of projects/implementations
Build and demonstrate an understanding of relevant business areas' leadership, structure, responsibilities, and work flow
Conduct deep dive program reviews with relevant internal and/or external stakeholders to identify opportunities for continuous improvement

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 Operational Support, Business Analysis or Project Management experience
2+ years of experience working with vendor relationships
Experience managing projects involving operational initiatives
Operations experience within a matrix organization
Experience leading matrix organizational projects/initiatives, preferably in a healthcare insurance, provider environment, or benefits management
Experience managing project resources (indirectly: 5-15 people) and mentoring staff
Ability to travel minimally, for 1 or 2 meetings a year at vendor sites (MN or WI)
Bachelor’s degree or equivalent work experienced

Preferred Qualifications:
Healthcare administration or healthcare benefits administration experience
Ability to quickly build strong meaningful relationships both internally and externally
Experience in the healthcare or benefits administration industry
Ability to prioritize and handle large volumes of operational tasks and projects simultaneously
Ability to communicate complex information tailored specifically to the audience so that it is easily understood
Ability to stay calm in difficult and highly stressful situations
Government healthcare (Medicare/Medicaid) programs experience
Careers at UnitedHealthcare Employer & Individual. We all want to make a difference with the work we do. Sometimes we're presented with an opportunity to make a difference on a scale we couldn't imagine. Here, you get that opportunity every day. As a member of one of our elite teams, you'll provide the ideas and solutions that help nearly 25 million customers live healthier lives. You'll help write the next chapter in the history of health care. And you'll find a wealth of open doors and career paths that will take you as far as you want to go. Go further. This is your life's best work.(sm)

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.