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Senior Client Operations Specialist - Multiple Locations

UnitedHealth Group


Location:
Columbia, MD
Date:
06/23/2017
2017-06-232017-07-22
Job Code:
1736579
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Job Details


Senior Client Operations Specialist - Multiple Locations(Job Number:709512)
Description

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. You'll help improve the health of millions. And you'll do your life's best work.(sm)

 

The Client Operations Analyst is responsible for the day to day and end to end management and service needs of Government Programs clients by ensuring accurate and timely implementation and maintenance of all operational aspects of our contracts.  The analyst will use his / her strong business analysis skills to work with our internal clients to gather the necessary requirements for successful product implementations and issue resolutions. In addition, they will work as an account manager accountable for the maintenance, growth and overall customer satisfaction for their book of business. 

 

Primary Responsibilities:

  • Serve as the liaison to collaborate and coordinate between all of the different departments that support our clients to meet ongoing business and project requirements. This includes Vendors, Clinical, Professional Networks, Provider Services, Call Centers, Finance, Legal, Auditors, Reporting team, Compliance and external parties
  • Manage the implementation of new products or lines of business as well as ensure expansion opportunities (i.e., new plans / groups) are incorporated into existing book of business
  • Facilitate the resolution of any issues, enhancements or process changes that arise during the course of day to day operations
  • Ensure network products, fee schedules and other operational requirements are set up in timely and accurate manner
  • Host and document (via agendas and minutes) all cross-departmental and organizational meetings as required to support the ongoing business and project requirements
  • Manage project plans, user acceptance testing, document requirements and supporting documentation
  • Proactively meet with health plan personnel and determine current and future business and regulatory needs
  • Review the contract to ensure we maintain contract compliance
  • Perform annual desk audits to ensure all of our clients supporting documentation is up to date (provider manuals, QRGs, plan summaries, org charts, etc.)
  • Coordinate all reporting needs for each assigned client
  • Work through any encounter file issues impacting clients; coordinating meeting with NEMIS, Provider Services and Scion to work issues through to resolution
  • Identify process improvement and cost savings opportunities when appropriate
  • Partner with the Clinical Department to ensure there is support (and provide benefit detail as needed) in support of Member Fair Hearings and provider complaint requests
  • Facilitate Ad Hoc requests (i.e., claim projects / research, eligibility research, utilization, network issues, reports, output verification, etc.) for completion in a timely manner
  • Support clinical initiative (i.e., HEDIS, ER Diversion, ECC, Dental Home) project work as needed

Job Business Analysis
Primary Location US-MD-Columbia
Other Location US-MN-Minneapolis, US-CT-Hartford, US-IL-Chicago
Organization E&I Spec Ben - Dental
Schedule Full-time
Number of Openings 2
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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