Implementation Member Eligibility Analyst - Telecommute

Company: UnitedHealth Group
Location: Minnetonka
Posted on: May 8, 2022

Job Description:

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)At OptumCare, we seek to enhance the performance of the health care system and improve the overall health and well-being of the people we serve and their communities. -We are building OptumCare's Foundation for the Future - Building a turnkey, physician and consumer centric operating and technology platform that delivers the highest quality, best outcomes, highest satisfaction experience and lowest cost national ambulatory network. -When you join us as a Sr Business Analyst - Eligibility, you will have the opportunity to be a part of our Foundation for the Future. -The Implementation Eligibility Business Analyst will participate on a team to implement new business and expansions for OptumCare. -Reporting to the Eligibility Implementation Lead, you will act as a Business Subject Matter Expert to the IT team, representing the voice of the business by performing analysis and capturing business requirements developing them into actionable features/user stories, establishing acceptance criteria, and identifying business process improvements. - -You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. -Primary Responsibilities: -

• Acts as the subject matter expert representing the business with the ability to clarify requirements, prioritize work, and drive requirements to acceptance thru the software development lifecycle -
• Participates in solution analysis and design meetings -
• Supports membership data validation and audits for go-live readiness -
• Maintains project plan needs and updates -
• Supports implementation testing needs -
• Works closely with implementation production teams to coordinate/collaborate on goals and requirements -
• Facilitates access and functionality needs of supporting source of truth portal/tool needs -
• Communicates and reports out downstream impacts cross-functionally -
• Supports system to system member fallout monitoring -
• Self-motivated and able to work with little direct supervision and drive results with disciplined follow-though -
• Strong strategic thinking and business acumen with the ability to align people related strategies and recommendations with business objectives -
• Experience driving decision-making with teams and management -
• Experience working with cross-functional teams -
• Ability to effectively break down barriers to maintain progress on deliverables -
• Diplomatic with effective negotiation and conflict resolution skills -
• Ability to make quick decisions when clarification or modification is needed -
• Self-directed and able to drive deliverables to completion with minimal oversight -
• Detail oriented and obsessively organized -You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.Required Qualifications: -
  • 4+ or more years of experience working in end-to-end Member eligibility/Enrollment management activities, including but not limited to: oversight of Member Eligibility loads, exception management, eligibility roster reconciliation, change file vs full file processing, etc. -
  • 3+ years of experience in working with new Medicare plan implementation
  • Experience working with health plans managing eligibility data used for Claim Payment systems -
  • Experience working with business partners to gather project requirements
  • Experience driving decision-making with teams and management -
  • Proven experience with process mapping, and documentation writing -
  • Proven experience presenting to business leaders
  • Experience working in member Eligibility and Enrollment systems, preferably Facets -
  • Proven experience with project oversight and management: planning, roadmap, timeline, risk management, issue resolution -
  • Experience working with cross-functional teams -
  • Testing and use case development experience -
  • Ability to travel up to 20% -
  • -Full COVID-19 vaccination is an essential requirement of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliancePreferred Qualifications: -
    • Experience working in Agile environment -
    • Experience working on a systems migration project -
    • Member Eligibility/Enrollment team at a delegated risk bearing provider organization or a healthcare insurance organization -
    • Implementation Lead/Manager or Business Analysis experience -
    • Knowledge of Medicaid and Medicare rules applicable to Member Eligibility and Enrollment -To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)OptumCare is committed to creating an environment where physicians focus on what they do best: care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians. -Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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. - -OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. -

Keywords: UnitedHealth Group, Minnetonka , Implementation Member Eligibility Analyst - Telecommute, Professions , Minnetonka, Minnesota