Eligibility Operations Lead

Posted Yesterday
Be an Early Applicant
Dallas, TX, USA
In-Office
24-43 Hourly
Mid level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
Coordinates Eligibility Operations execution by tracking inventory, monitoring aging items, validating status reports, facilitating leader huddles, escalating risks, resolving issues, and following up on operational commitments. Supports backlog management, urgent requests, audit controls, HIPAA and SOX compliance, and domestic and global team coordination. Requires independent problem-solving, effective communication, analytical skills, and adherence to defined processes in a remote environment.
Summary Generated by Built In
Requisition Number: 2383152
This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
You dream of a great career with a great company - where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it's a dream that definitely can come true. Already one of the world's leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up. This opportunity is with one of our most exciting business areas: Optum - a growing part of our family of companies that make UnitedHealth Group a Fortune 5 leader.
Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation and Performance.
This position is full time. Employees are required to have flexibility to work any of our shift schedules during our normal business hours of 8:00 am - 5:00 pm local time.
This will be on the job training. The hours of training have no defined timeline. Training will be remote.
Primary Responsibilities:
  • Supports operational execution across Eligibility Operations by coordinating work completion, tracking inventory commitments, monitoring aging items, validating status reporting, supporting facilitation of leader huddles, and following up on escalated operational risks
  • Escalates operational barriers, resource constraints, and aging inventory risks to leadership for resolution
  • Supports daily execution follow-through
  • Supports leader in coordinating domestic and global team efforts against inventory priorities
  • Troubleshoots escalated issues from internal departments that interrelate with eligibility submission and processing
  • Takes ownership of issues. Thinks through issues and finds solutions. Looks at whole picture, not just individual piece of an issue. Ability to make sound decisions
  • Coordinates follow-up activities related to inventory priorities, operational commitments, and leadership action items
  • Follow through with error issues to resolution with frequent communication for update and resolution status
  • Researches and responds to unique and escalated questions and issues from internal customers
  • May assist in working urgent requests, or working inventory in times of backlog or increased inventory volumes to support team
  • Adhere to all key audit controls and comply with all established standards associated with HIPAA, and SOX
  • Serves as an execution coordinator to help ensure operational priorities are completed timely and accurately
  • Other duties as assigned. Work may be self-prescribed and directed

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:
  • High School Diploma / GED OR equivalent work experience
  • Must be 18 years of age OR older
  • 3+ years of experience with progressive responsibility with process improvement initiatives
  • 3+ years of experience working within Microsoft Excel with the ability to filter and sort
  • 2+ years of data analysis experience
  • 1+ years of experience working in a remote capacity with minimal supervision
  • Moderate proficiency with Microsoft Office (Microsoft Word, Microsoft Excel, & Microsoft Outlook) experience
  • Ability to work any of our full time (40 hours / week), 8-hour shift schedules within the operating hours of the department (8:00 am - 5:00 pm local time).

Preferred Qualifications:
  • Facets experience
  • Enrollment / Eligibility experience
  • Health care experience

Telecommuting Requirements:
  • Ability to keep all company sensitive documents secure (if applicable)
  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Soft Skills:
  • Communication, writing skills, time / project management, problem solving, organizational, and analytical skills
  • Ability to solve problems, follow defined processes, make independent decisions, and apply them to problem results
  • Ability to be proactive
  • Ability to apply quality measures / measurements in day-to-day work
  • Experience with issue resolution
  • Ability to work independently with rapid learning curve
  • Computer skills, including working knowledge of MS Windows and mouse and keyboarding skills

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $24 - $43 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Skills Required

  • High School Diploma, GED, or equivalent work experience
  • At least 18 years of age
  • 3 or more years of experience with progressive responsibility in process improvement initiatives
  • 3 or more years of experience using Microsoft Excel, including filtering and sorting
  • 2 or more years of data analysis experience
  • At least 1 year of experience working remotely with minimal supervision
  • Moderate proficiency with Microsoft Office, including Word, Excel, and Outlook
  • Ability to work full-time 40-hour weeks on any 8-hour shift within 8:00 a.m. to 5:00 p.m. local operating hours
  • Ability to secure company-sensitive documents and maintain a dedicated private remote work area
  • Ability to access UnitedHealth Group-approved high-speed internet
  • Facets experience
  • Enrollment or eligibility experience
  • Healthcare experience
  • Communication, writing, time management, project management, problem-solving, organizational, and analytical skills
  • Ability to work independently, learn quickly, follow defined processes, and make independent decisions
  • Ability to apply quality measures and resolve issues
  • Successful completion of a drug test before employment

What the Team is Saying

Optum Compensation & Benefits Highlights

  • Leave & Time Off Breadth — PTO is generally described as decent or good, and many note it as a strong part of the package. Actual ability to take time off can depend on workload and team coverage.
  • Retirement Support — Offerings include a 401(k) with employer match and access to an employee stock purchase plan, which are highlighted as meaningful components of total rewards. These programs are consistently referenced among core benefits.
  • Parental & Family Support — Parental and caregiver leave, along with adoption assistance, are publicly highlighted and viewed as notable elements of the package. Availability can be role-specific, but these supports contribute to overall breadth where offered.

Optum Insights

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The Company
HQ: Eden Prairie, MN
160,000 Employees
Year Founded: 2011

What We Do

Optum, part of the UnitedHealth Group family of businesses, is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.

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Optum Offices

Hybrid Workspace

Employees engage in a combination of remote and on-site work.

Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.

Typical time on-site: Not Specified
HQEden Prairie, MN
Metro Manila, Philippines
Cebu, Philippines
Davao, Philippines
Ann Arbor, MI
Atlanta, GA
Baltimore, MD
Bengaluru, India
Chennai, India
Dallas, TX
Detroit, MI
Dublin, Ireland
Hartford, CT
Houston, TX
Hyderabad, India
Jacksonville, FL
Las Vegas, NV
Letterkenny, Ireland
Louisville, KY
Madison, WI
Minneapolis, MN
Nashville, TN
New Delhi, India
Philadelphia, PA
Phoenix, AZ
Pune, India
Raleigh, NC
San Diego, CA
Washington, DC
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