Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start
Caring. Connecting. Growing together.
This position maintains relationships with existing trading partners, including outreach when files are missing or have a problem in the data, requests to update agreements, address outstanding data update requests. This role also handles inbound trading partner data and performs initial inbound data mapping and review.
Update Outreach: reach out to contacts at each trading partner when an update to their agreement is needed, usually due to a new product or service offering.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities - Prioritizing trading partners for outreach
- Sending emails to existing/known contacts maintained in CRM software
- Discovering new contacts through relationships with internal and external stakeholders
- Following up on and maintaining records of correspondence
- Scheduling and driving meeting discussions to answer questions
- Identifying correct participants to address call agendas (managers, attorneys, IT contacts if applicable etc)
- Maintaining consistent follow ups until completion or trading partner declines interaction
- Acquire new trading partners: Researching contact information for priority carrier targets and approach payers that do not have established data feeds with goal of executing a new Trading Partner Agreement
- deriving contact information for payer correspondence
- creating and developing standard emails and follow up templates for consistent correspondence
- scheduling calls to address questions from business
- collaborating with Legal counsel to request draft agreements
- coordinate negotiations with internal and external legal counsel during redline process and other required activities
- Implement new trading partner data files: establish ongoing relationship with payers after executing trading partner agreement and kickstart implementation of eligibility feeds by our IT department
- identifying correct technical contact(s) at the new trading partner
- coordinating ECG ticket creation to establish EDI transmission of eligibility files
- scheduling and driving meetings with the new trading partner to discuss submission requirements
- work with raw inbound trading partner test files to create initial data mapping to ensure successful ingestion of new data feeds
- coordinate between internal and external stakeholders
- maintain relationship with business contacts after new trade partner data is onboarded to ensure submissions meet COB business standards
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 of experience with electronic claim, remittance, or eligibility file
- 1+ years of experience in account or client management
Preferred Qualifications
- 1+ years of experience with data mapping
- Experience as a Paralegal, contract reviewer and/or currently pursuing a law degree
- Proficient in Microsoft Office365 applications
Soft Skills
- Proven excellent written and spoken interpersonal communication skills
- Proven ability to react quickly with purpose to advance objectives while maintaining professional tone and demeanor in challenging negotiations
- Proven prioritization and progress tracking on multiple initiatives, multi-tasking organizational skills
- Proven organization skills to maintain documentation for all communications and actions
- Proven consistent and focused follow up on complex and long-running negotiations
- Proven conduct research for membership trends to support Quality processes with internal stakeholders
- All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.
The salary range for this role is $59,500 to $116,600 annually based on full-time employment. 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.
#RPO
