At UnitedHealthcare, were simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your lifes best work.SM
This position is full-time. Employees are required to work our normal business hours of 8:00am 5:00pm.
We offer weeks of on-the-job training. The hours during training will be 8am to 5pm, Monday - Friday.
*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.
Primary Responsibilities:
- Assigned to certain customers and maintains their own book of business that may consist of National Account (NA) and Key Account (KA) business segment cases to deliver contract Summary Plan Description (SPD) expertise and consultative services on all matters relating to the SPD
- Responsible for working closely with the account representatives on the case NA becomes actual member of the Account Management Team (AMT) and has direct client face out responsibility Delivering Contract SPD Expertise and SPD Consultative Services
- For NA cases responsible for direct client face out responsibility in form of telephonic, written and or live interaction (when deemed appropriate)
- Responsible for the creation, and completion of SPDs that include both medical and ancillary products and the full UHC product line (excludes M&R and UMR business) within agreed upon delivery dates
- Responsible for delivering and executing Material Modification Updates (MMU) and Summary of Material Modification (SMM) process for book of business within agreed upon delivery dates
- Reviews, interprets, and extrapolates benefit information and language from client source of truth documentation, main reference sources Benefit Template Builder (BTB), Benefit Grid, On-Board Manager (OBM), BPL/PhBit, TCR and data sources in DBD to produce draft & final SPDs for assigned accounts and plans
- Maintains close working relationship with wide range of account management and operational staff up to and including SAE/IM/IPM/CM
- Ability to manage a large vol. of cases and to be able to source/prioritize multiple SPDs/projects at one time; and meet or exceed unit metrics for production of SPD
- Keep abreast of the latest legal/SPD/product and HCR updates and impacts and apply to existing book of business and SPDs
- Responsible for producing high quality product that is delivered to assigned customers subject to quality assurance (QA) program review and metrics
- Reviews customer produced SPDs by comparing source of truth documentation with customer language. Sends customer produced SPD to reviewers on the account management team to review certain aspects of the SPD.
- Sends resource balances for Certificates of Coverage (COC) to the fully insured Contract team
- Leads or participates in process improvement projects
Required Qualifications:
- Must be 18 years of age or older
- 3+ years of administrative experience with extensive exposure to benefit administration
- Proficiency with Microsoft Word (create, correspondence, edit, save documents, and work within templates)
- 3+ years of experience in high-volume work processes
- 3+ years of experience in detailed editing, documents or account management
- Ability to work our normal business hours of 8:00am to 5:00pm
- Experience working in healthcare/benefit/Contract SPD/legal - including client management, claims, on-boarding, eligibility, and operations
- BTB/Benefit Summary experience
- Customer Service / XML Tagging experience
- Prior Account Management Team experience
- Complex account management experience
- Key Accounts and National Accounts experience
- Experience working in Com360/DOC360/Cirrus
- Prior experience with benefit and contract/ SPD/ legal acumen
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
- Strong grasp of benefit and contract/SPD/legal acumen
- Ability to deal with multiple clients and deadlines
- Ability to prioritize work
- Attention to detail up to an including spelling, formatting, and grammatical details
- Ability to act with little supervision
- Effectively works in a matrixed team environment
- Good interpersonal, communication, and presentation skills
- Good relationship and team building skills
- Displays a strong level of initiative
- Strong communication and presentation skills
- Strong organization and initiative-taking management skills
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyoneof every race, gender, sexuality, age, location, and incomedeserves 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.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer, 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.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
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