No industry is moving faster than health care. And no organization is better positioned to lead health care forward. We need attention to every detail with an eye for the points no one has considered. You'll help improve the health of millions. And you'll do your life's best work.(sm) The Business Analyst for the Community and State (C&S) Maryland Medicaid health plan is a key member of the operations team, responsible for maintaining key relationships with our State customer, including responding to and resolving oral and written member complaints and appeals. In addition, this position is accountable for delegated entity oversight of external business partners that provide services and benefits to C&S Maryland health plan members. The Business Analyst must be self - directed, able to analyze and develop solutions to complex issues, and efficiently respond to non - standard and ad hoc requests. This role serves as a subject matter expert for health plan policies and procedures. This role is based in the office daily in Columbia Maryland. Primary Responsibilities:Foster and maintain a collaborative relationship with internal and external business partners to ensure timely resolution of State customer requests Receive, document, process and resolve state - level provider, physician and / or member grievances Serve as primary resource to senior management, plan sponsors, members, and State customerOversight of delegated entity contracts and service level performance of vendor partners to support short and long term operational and strategic business goals Ensure all State and internal requirements are met Oversight of internal standard operating procedures and reporting related to delegated vendor operations
Required Qualifications:Bachelor's degree in Business, Health Administration or related field 2+ years of experience in a client relations, issue resolution, and / or consumer affairs specialist rolePreferred Qualifications:2+ years of health care industry experience is highly desired 2+ years of experience facilitating resolution of escalated complaints and issues 1+ years of experience with Medicaid regulations and / or health plan policies and procedures 1+ years experience in business analysis or project management Intermediate level of proficiency with PC based software programs and automated database management systems (Access, Excel, PowerPoint, Word, Outlook) Outstanding Organizational skills - being able to multi task prioritize work as needed to meet and exceed standard turnaround times Excellent Written and Verbal communication skills - must be able to communicate ideas and analysis in a clear concise fashion to State customers, external business partners, internal colleagues and senior business leaders Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV/AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm) 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. Job Keywords: Columbia, Maryland, MD, Medicaid, hotline, consumer relations, customer services, healthcare, appeals, business analyst, business analysis, consumer affairs, customer issues, issue resolution, health plan
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 t...hey 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.