We'll put you in the driver's seat on vital projects that have strategic importance to our mission of helping people lead healthier lives. Yes, we share a mission that inspires. We need your organizational talents and business discipline to help fuel ours. It's the opportunity to do your life's best work.(sm)
This Quality Assurance Specialist position is required to handle increased workload associated with Prior Authorization system setup. The Prior Authorization system setup includes the loading of letters, updating of tables, loading clinical guidelines, and updating automated decision trees. This role is vital since without it we will risk incomplete guidelines, incomplete or incorrect approval and denial letters loaded for each client for each migration resulting in increased cost to client and decreased member satisfaction.
Positions in this function include those responsible for providing process and operational support to the functions within Business Operations Family. Positions in this function may also be responsible for quality reporting, analysis and audits, and for developing plans and programs to support continuous quality improvement using applicable tools. Employees in jobs labeled with SCA must support a government Service Contract Act (SCA) agreement.
Enter incoming audits/CAPs into Access database
Sort/distribute mail; scan documents for archives and regulatory purposes
UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.
We are committed to introducing innovative approaches, products and services that can improve personal health and promote healthier populations in local communities. Our core capabilities... in clinical care resources, information and technology uniquely enable us to meet the evolving needs of a changing health care environment as millions more Americans enter a structured system of health benefits and we help build a stronger, higher quality health system that is sustainable for the long term.
We serve our clients and consumers through two distinct platforms:
?UnitedHealthcare, which provides health care coverage and benefits services.
?Optum, which provides information and technology-enabled health services.