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Claims Operations Manager - Albuquerque, NM

UnitedHealth Group

Albuquerque, NM
Job Code:
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Job Details

Claims Operations Manager - Albuquerque, NM(Job Number:727680)

Position Description:


You'll join a high caliber team where you're assisting, educating, problem-solving and resolving tenuous situations to the best possible outcomes. Bring your people skills, emotional strength and attention to detail. Get ready to start doing your life's best work.

The Claims Operations Manager is responsible for staff management, administration of multiple functions and management of general business operations within the Claims Organization.

Primary Responsibilities:

  • Oversee daily operations of multiple levels of staff and multiple functions across one or more business units.
  • Manage day to day site operations, leadership (internal and external to organization), and accountability for financial and non-financial results (budgets and actuals).
  • Provide oversight and authorization to ensure appropriate payment on claims occurs
  • Conduct analysis of quality trends and claim re-work; provides improvement plans as necessary.
  • Lead project management and implementation initiatives.
  • Positions in this function are responsible for performance guarantee attainment, contract compliance, regulations at the federal and state level, quality outcomes within established policies and procedures.
  • Ensure expertise or general claims support is provided to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims
  • Manages and is accountable for professional employees and / or supervisors.
  • Impact of work is most often at the local level.
  • Responsible for all aspects of performance including coaching and development, career progression, employee engagement and effective communication.

Job Claim Operations
Primary Location US-NM-Albuquerque
Other Location 
Organization C&S Ops - Medicaid Claims
Schedule Full-time
Number of Openings 1
Apply on the Company Site

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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