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Manager of Claims and Clinical Configuration Analysis - Telecommute

UnitedHealth Group

Minnetonka, MN
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Job Details

744309 Manager of Claims and Clinical Configuration Analysis Telecommute

Manager of Claims and Clinical Configuration Analysis - Telecommute (744309)

Position Description

If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm)


We have an opportunity for a Claims Configuration Manager with experience in building and configuring claim related requirements within a business configurable system (e.g. Facets).  In this role you will be supervising a team of configuration analysts in the design, build, and validation of complex system configuration changes and new configuration requirements including configuration analysis, design, build and test.  Duties include overseeing troubleshooting and fixing system configuration errors, performing investigations and root cause analysis of trouble tickets, and ensuring day to day issues are identified and appropriately addressed. 


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


Primary Responsibilities:

  • Configuration Team Leadership

    • Lead requirements gathering, service-oriented modeling, analysis and design activities

    • Evaluate business requirements and prepare detailed functional and technical specifications

    • Serve as the liaison between business and systems analysts, developers and project management groups

    • Develop detailed source-to-target data mapping and data transformation rules

  • Configuration Design

    • Analyzes claim requirements, designs/configures claim data, configuration validation, configuration peer review

    • Communicate design to all stakeholders and varying levels of the organization

    • Present and evaluate design solutions objectively and facilitate conflict resolution

    • Define, use and communicate design patterns and best practices in service oriented analysis, design and development

  • Configuration Build & Maintenance

    • Configuration of new business within a health plan configuration system (e.g. Facets)
    • Configuration of claims data within health plan configuration system (e.g. Facets)
  • Configuration Quality Assurance
    • Quality assurance and testing within health plan configuration system (e.g. Facets)to ensure configuration is ready for implementation
    • Collaborate with quality assurance team to ensure testing efforts align with system deliveries and business processes
    • Develop strategies to improve service development life cycle and governance processes
    • Develop and use enterprise service and data models Quality assurance and testing

Required Qualifications:

  • 5 + years of experience working in a business configurable system (e.g. FACETS)
  • 3 + years of staff supervision or team lead experience
  • 3 + years of experience identifying to patterns within quantitative data, draw conclusions and recommend solutions and approaches, skilled with end to end issue resolution
  • Intermediate or greater level of proficiency with Microsoft Excel and Word
  • Experience in metrics based monitoring in both individual and team performance
  • Travel of 25-50% if applicant outside of MN
Preferred Qualifications:
  • Bachelor’s Degree in Business Administration or related area
  • Excellent oral and written communication skills, interpersonal skills and organizational abilities are essential
  • Ability to work effectively with minor supervision
  • Claim Configuration experience
  • Product & Benefit Analysis knowledge
  • Provider Pricing Analysis knowledge
  • Ability to provide analysis, problem solving, and interpret application configuration
  • Good knowledge of data structures within a health plan configuration system (e.g. Facets)
  • Clearly articulate (both verbal and written) project status and issues management
  • Ability to interact effectively with other areas of the organization regarding Claims Transactions
  • Ability to manage multiple assignments while maintaining quality standards and meeting assigned deadlines
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 14 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.(sm)
*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy. 

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 Details

  • Contest Number744309
  • Job TitleManager of Claims and Clinical Configuration Analysis - Telecommute
  • Job FamilyBusiness Operations
  • Business SegmentUHC Benefit Ops - EandI Ops

Job Location Information

  • Minnetonka, MN
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelManager
  • ShiftDay Job
  • TravelYes, 25 % of the Time
  • Telecommuter PositionYes
  • Overtime StatusExempt

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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