Position Description:If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Financial discipline and accountability count more today than ever. Which is why your performance and innovation will find a reception here like nowhere else as you help people live healthier lives while doing your life's best work.(sm)In providing consumer - oriented health benefit plans to millions of people; our goal is to create higher quality care, lower costs and greater access to health care. As a finance professional, you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system.Primary Responsibilities:Oversees and manages the production schedules for pharmacy payment batches, tracer activity, projects and reporting. These activities are performed by onshore and offshore team members.Perform account reconciliations and analysesAssists on external and internal auditsGenerate standard and ad - hoc reports as requiredDevelop innovative approaches for continued improvement in efficiency and effectiveness.Assist with complex reconciliations that involve Billing and Payment data. In addition, perform, analyze and report on findings of the reconciliationAssist with running and analyzing reports from claims data warehouse, RxC online reporting tools, MS Access & ExcelPartner with other departments, including Retail Network Ops, Provider Relations, Claims Operations and IT for payment batch / checks monitoring, payment tracer questions and other ad - hoc processesReviews weekly RXACH schedules and payment filesPerforms network audit payment hold activitiesAssists in creating yearly payment schedulesPerforms key SOX controls for pharmacy payment accuracy, completeness and cutoffPerforms weekly unclaimed and abandoned property activitiesPrepares reporting for client performance guarantees and CMS / state regulators for prompt pay complianceProvides payment backup support for COGS / Claim Payable and billing / revenue Blackline reconsOther related duties as assigned
Required Qualifications:Bachelor's Degree (or higher) OR High School Diploma / GED with 8+ years in a business operations role3+ years of professional experience in business management, finance, accounting, or related functionExperience with data mining / query or analyticsProficiency with Microsoft Office (specifically Microsoft Excel)Previous experience in payment operations (ex: electronic fund transfers, tracers, complex reconciliations, internal / external audits, yearly payment schedules, etc.)Preferred Qualifications:Bachelor's Degree (or higher) in Business Administration / Management, Accounting, Finance, or related function. Healthcare backgroundPrevious CPA experienceExperience with business operations.Previous project management experienceSoft Skills:Strong verbal and written communication skills as the position requires interfacing with other departments and clientsStrong analytical skills; detail oriented, as well as ability to see 'big picture'Ability to work and contribute in a team environment, as well as work independentlyAbility to take initiative and accountability for work product and able to meet deadlines Solves complex problems on own; proactively identifies new solutions to problems.Ability to plan, prioritize, organize and complete work to meet established objectives.Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system 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.SMDiversity 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.Keywords: UnitedHealth Group, Payment Operations Specialist, Irvine, CA, California, finance, accounting, business management, business operations, payment operation, ETF,
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.