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MSLA - Claim Manager - Independent Medical Exams & Qualified Medical Exams - Cypress, CA

UnitedHealth Group

Cypress, CA
Job Code:
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Job Details

MSLA - Claim Manager - Independent Medical Exams & Qualified Medical Exams - Cypress, CA(Job Number:706522)

MSLA is a Medical Corporation that provides comprehensive independent medical evaluations (IME) and other IME related services to the government and private industry. Our business philosophy incorporates both exceptional customer service and quality evaluations, both of which are the primary factors for our rapid growth since our inception in 1998. No industry is moving faster than health care. And no organization is better positioned to lead health care forward. We need attention to every detail with an eye for the points no one has considered. The rewards for performance are significant. You'll help improve the health of millions. And you'll do your life's best work.(sm)
This position is responsible for the general operational oversight of the IME and QME department. The Claim Manager will work with key members of the business team and executives to ensure that day-to-day business objectives are met and client expectations are exceeded.  The manager will support our existing IME, Peer Review and other services while helping the company to expand our portfolio of services to meet industry needs. The manager will also have responsibility for business growth and bottom line financial results.
Primary Responsibilities:
  • Responsible for overall production, performance and quality of the IME Business
  • Provide leadership and directly supervise team members to ensure performance expectations and milestones are achieved
  • Work as a point of contact to effectively understand the unique client needs; Manage new client onboarding process; Interacts with clients to strengthen/expand existing relationships and to ensure appropriate and timely resolution of service issues; Recommends solutions for meeting these needs through process mapping analysis, resource allocation, and division of labor
  • Identify potential new clients and new lines of business; participate in prospective and current client meetings
  • Work with business leaders and technology team to improve process and system support
  • Sets team direction, resolves problems and provides guidance to the team members
  • Develop and monitor goals for staff and the department, providing regular on-going feedback and coaching
  • Conduct regular self-audits of department results, processes and workflows. Analyze the information to improve outcomes and maximize productivity
  • Identify opportunities and implement process improvements to optimize outcomes and mitigate costs;
  • Accountable for maintaining effective internal controls over the processes and transactions;
  • Adapts departmental plans and standard operating procedures to address business needs;
  • Influence and/or provides input into forecasting and planning activities;
  • Responsible for managing doctor utilization to ensure they are meeting contractual expectations and timelines
  • Assist on RFP’s
  • Lead and/or participate in workgroups and committees
  • Perform other duties as assigned or required by operational need, or as assigned by Management
  • Demonstrated ability to lead and motivate others
  • Demonstrated ability to work independently, and in conjunction with team members at all levels of the organization
  • Ability to work in a high volume environment with emphasis on accuracy and timeliness
  • Demonstrated ability to think strategically, and execute operationally and tactically
  • Able to process mapping and evaluate metrics to continuously improve results
  • Able to understand instructions furnished in written, oral, diagram, or schedule form
  • Excellent verbal and written communication skills
  • Critical thinker, solution driven and self-motivated
  • Organized, detail oriented,  and articulate
  • Proficient in general computer use and Microsoft Office Suite

Job General Operations Management
Primary Location US-CA-Cypress
Other Location 
Organization Logistics Health Inc
Schedule Full-time
Number of Openings 1
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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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