The Role
Lead and manage collections/audit team for healthcare revenue cycle operations. Oversee client relationships, performance metrics, process improvement, denial management, budgeting, staffing, reporting, and compliance. Drive quality initiatives, support production teams, prepare business plans and value-stream analyses, and provide regular coaching and operational recommendations to senior management.
Summary Generated by Built In
Requisition Number: 2358439
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.
Primary Responsibilities:
Required Qualifications:
Preferred Qualifications:
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.
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.
Primary Responsibilities:
- Manage overall personnel, performance, and discipline of the audit team members for different processes
- Provide expertise and leadership in assigned functional area
- Manage relationship with internal stakeholders and functions
- Manage all client interaction and client communication and have front end the relationship with the client
- Periodic review and analysis of all reports and metrics
- Provide support to the Production Team and Supervisors to continually improve their performance and meet Service Level Agreements/Performance Guarantee goals
- Evaluation of operational practices and procedures
- Provide support to quality initiatives targeted towards process improvements
- Be actively involved in the internal audit support; ensure all compliance parameters are met
- Establish and maintain a working environment conducive to positive morale, individual style, quality, creativity, and teamwork
- Provide direction to staff; ensure resolution of problems; set priorities
- Actively provide inputs and assistance to the senior management in the planning, implementation, and evaluation/modifications to existing operations, systems, and procedures, specifically relating to his/her assigned project(s)
- Manage attrition and building retention strategies
- Preparation of annual business plans including operating budgets
- Negotiate solutions, resolve conflicts and anticipate/handle critical situations
- Provide regular performance feedback and give frequent formal and informal coaching sessions
- Work with business partners to identify ways to improve business processes
- Prepare process Value stream mapping, identify non value adds in the process and work towards elimination using different tools and technologies
- Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
Required Qualifications:
- Bachelor's degree with US Healthcare provider experience, specifically in A/R recovery/Payment posting/Billing (RCM - Revenue Cycle Management services)
- 13+ years of experience on RCM- Backend operations
- 10+ years of experience in handling denial Management and credits
- 6+ years of experience in handling large teams
- Working knowledge of budgeting, cost estimating, capacity utilization principles and procedures
- Proven expert in preparation of excel reports and PowerPoint presentations
- Demonstrate the ability to communicate effectively both verbally and in writing. Attention to detail and demonstrate the ability to perform deep dive AR analysis
- Proven ability to multi-task and prioritize in order to complete daily tasks with minimal supervision
Preferred Qualifications:
- Proven ability to review and handle appropriately:
- Knowledge on handling Hospital clients with California client will be an added advantage
- Familiar with payer contracts and approach
- Adhere to quality improvement initiative
- Special projects
- Proven calibration process:
- Proven ability to actively participate on calibration and collaborate with support functions
- Proven ability to give correct resolution of agenda asked by operations
- Proven ability to handle and give justification of rebuttals if required
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.
Skills Required
- Bachelor's degree with US healthcare provider experience in A/R recovery, payment posting, or billing (RCM)
- 13+ years of experience in RCM backend operations
- 10+ years of experience handling denial management and credits
- 6+ years of experience managing large teams
- Working knowledge of budgeting, cost estimating, and capacity utilization principles
- Expertise in preparing Excel reports and PowerPoint presentations
- Strong verbal and written communication, attention to detail, and ability to perform deep-dive AR analysis
- Ability to multi-task, prioritize, and work with minimal supervision
- Knowledge of handling hospital clients (California client experience an advantage)
- Familiarity with payer contracts and approaches
- Experience with quality improvement initiatives and special projects
- Experience with calibration processes, cross-functional collaboration, and handling rebuttals
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The Company
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
