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Senior External Audit Consultant - Current UHG Office or Current US Telecommute

UnitedHealth Group

Minneapolis, MN
Job Code:
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Job Details

Senior External Audit Consultant - Current UHG Office or Current US Telecommute(Job Number:732268)

Position Description:

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.

Our claims operations are the focal point of handling information about services patients receive and the way those services get paid. It's complex, detailed work. It's a fast paced challenge. It's a job that calls on you to be thoughtful, resourceful, team - driven and customer - focused. To put it mildly, there is never a dull moment.

As a key member of the team, you will support Benefit Operations, and readiness reviews for external audits. Individual serves a single point of contact for external partners and internal business partners and brings forward to Benefit Operations the audit scope as it relates to operational process reviews and defines operational involvement. This position is a functional SME, has a broad business approach, develops pioneering approaches to emerging industry trends and is a resource to senior leadership. It has oversight of related activities across functional areas and communicates project progress through stage gate reviews and documented adherence action plans in accordance to operational readiness review model.

Primary Responsibilities:

  • Implement claim payment processes that meet regulatory requirements and claim business rules. 
  • Conduct claims systems utilization, capacity analysis / planning and reporting, and claims-related business and systems analysis. 
  • Ensure data integrity, data security and process optimization.
  • Serve as our internal Regulatory Affairs' point of contact
  • Partner with functional area leaders and SME's to determine impact and solutions
  • Implement Claim Ops solutions to meet regulatory requirements
  • Lead Claim Ops market conduct or financial exam activity, corrective action plans responses and restitution projects
  • Remediate gaps in existing production processes that do not meet regulatory requirements.

Job Claim Business Process
Primary Location US-MN-Minneapolis
Other Location US-FL-Tampa, US-TX-Dallas, US-CT-Hartford, US-AZ-Phoenix
Organization External Audit
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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