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Associate Director ACE Innovation and Growth - Telecommute job in Chicago at UnitedHealth Group

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Associate Director ACE Innovation and Growth - Telecommute at UnitedHealth Group

Associate Director ACE Innovation and Growth - Telecommute

UnitedHealth Group Chicago, IL Full Time

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

This is a key role in our strategy to deploy the Advanced Communication Engine (ACE) and ensure ACE is integrated into a broader range of Payment Integrity processes. This role will be responsible for the ongoing growth of the ACE tool and the development of additional use cases that generate value to the enterprise.

Optum/United Health Group is seeking an individual with solid business process and operations experience. Innovation and creative thinking are a must. Ability to drive future ACE solutions and generate agreement across the enterprise is a key component of success with this position. This is an exciting opportunity to make key contributions to this highly visible and strategic program.

This position is responsible for identifying new edit opportunities and new use cases to expand the value realization associated with the ACE program. Interacts with Payment Integrity staff, line of business leaders, Benefit Operations, and Optum Insight ACE program staff to identify new use cases. This role will assist in creating requirements for the use case and ensuring maximum positive impact is achieved. Makes recommendations for ACE strategic direction and roadmap to ensure a robust pipeline of enhancements. Calculates financial impact and benefit for new use cases.

This is a critical position to the success of the ACE program requiring a self - motivated individual who is responsible for managing the end-to-end processes associated with the seamless and quality rollout of the ACE solution. 

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

Primary Responsibilities:

Role will be focused on ACE expansion and the development of new edits and use cases that help the ACE program meet/exceed the value realization targets associated with the program. The ideal candidate will:

  • Understand, through data analytics, how provider claim submission impacts business operations and customers’ experiences
  • Present findings and conclusions clearly and concisely
  • Collaborate with other departments and leaders to identify opportunities to improve performance using ACE
  • Possess a proven ability to present solutions using both technical and non-technical
  • Service-driven to internal and external customers
  • Solid innovative thinker with an innate curiosity around data and operations
  • Self-motivated and possess the ability to manage multiple priorities and meet deadlines
  • Possess the capacity to work independently
  • Adapts departmental plans and priorities to address business and operational challenges
  • Influences or provides input to planning activities
  • Determine scope of requested work in order to assess resource requirements and create work plans
  • Demonstrate understanding of business terminology and acronyms in order to accurately interpret customers' request
  • Relentless in pursuit of opportunities and drive to closure

 

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 equivalent work experience
  • 5+ years of experience in an Operations or Payment Integrity role
  • 2+ years focused on operational process improvement
  • Experience with data analytics, how provider claim submission impacts business operations and customers’ experiences
  • Exposure to ACE or claims editing
  • Intermediate level of proficiency with Microsoft Office - Word, Excel, PowerPoint
  • Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance

Preferred Qualifications:

  • Certified professional coder
  • Solid written and verbal communication skills
  • Knowledge of Optum Care business lines
  • Ability to influence with and without direct authority
  • Experience functioning in a matrix / shared services organization
  • Experience using claims platforms such a UNET, Pulse, NICE, Facets, Diamond, etc. 
  • Experience launching and managing new healthcare initiatives / plans
  • Experience with CES (Claims Editing System) or other claims clinical editing programs
  • Proficiency in various claims payment methodologies; to include capitation, fee-for-service, DRG, percent-of-charge, and OPPS
  • Experience with Fraud, Waste, & Abuse (FWA) programs, or working within a Special Investigations Unit (SIU)
  • Proficiency in performing financial analysis / audit including statistical calculation and interpretation
  • Proficiency in various claims payment methodologies; to include capitation, fee-for-service, DRG, percent-of-charge, and OPPS
  • Proficiency using Microsoft Office: Word, Excel (data analysis, sorting / filtering, pivot tables), PowerPoint (prepare formal presentations and training), Visio (develop workflow processes)
  • Experience with public speaking and presenting to large audiences, including Executives and Medical Directors
  • Experience interpreting provider contractual agreements

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles require full COVID-19 vaccination as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers at OptumCare. We're on a mission to change the face of health care. As the largest health and wellness business in the US, we help 58 million people navigate the health care system, finance their health care needs and achieve their health and well-being goals. Fortunately, we have a team of the best and brightest minds on the planet to make it happen. Together we're creating the most innovative ideas and comprehensive strategies to help heal the health care system and create a brighter future for us all. Join us and learn why there is no better place to do your life's best work.(sm)

OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare’s support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado, Connecticut and/or Nevada residents is $94,500 to $171,700. 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.

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: Associate Director ACE Innovation and Growth, Optum, OptumCare, UHG, UnitedHealth Group, Telecommute, Telecommuter, Telecommuting, Work at Home, Work from Home, Remote

Recommended Skills

  • Auditing
  • Business Process Improvement
  • Business Processes
  • Certified Professional Coder
  • Claim Processing
  • Clinical Works
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