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UnitedHealth Group Sr. Business Analyst, Claims Manager / Ace - Telecommute Nationwide in Utah

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

As the Product Consultant, you will work directly with our external and internal customers while managing a portfolio of projects supporting internal and external customers. This position requires the highest level of professionalism, innovative approach and solutions, as well as the ability to understand and communicate CMS NCCI, Medicare, and Medicaid edits. You will also need to fully understand both Professional and Facility medical claims and how CMS interprets payment and reimbursement procedures.

As we build efficient and repeatable processes our team will deliver industry leading implementations that result in high NPS scores.

The individual in this role will provide a detailed level of support and guidance on a clinical coding software application during the implementation of the product. This person will also provide input on the system setup of the clinical coding software application.

The Product Consultant is responsible for the successful integration and configuration of various clinical editing solutions by new and existing customers. The successful candidate will have a strong healthcare background and industry knowledge as well as specific clinical coding experience that will allow them to provide consulting on how best to configure our solutions into our customers’ existing business practices and fully optimize to allow for the greatest return on their investment.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.


  • Assistclients with initial setup of the software during implementation

  • Assistin best practices of business decisions for setup of the application

  • Supportnew customers on the software until transition to support in order tobuild and maintain strong business relationships

  • Participatein onsite or virtual project kickoff where customer implementation team isbrought up to speed on solution features, functions, and capabilities

  • Participatein weekly calls and follow-up on any specific task assigned

  • Documentcorrespondence and activity

  • Documentingworkflow process

  • Troubleshootclient issues during implementation

  • Identifycritical client issues and communicate them to the appropriate staff forresolution / prevention

  • Assistin updating implementation documentation

  • Assistclients with go-live activities, testing and support (on-site or remote)

  • Assistcustomer through the design phase of the project providing business andproduct consulting and guidance on how best to integrate, configure, andoperate the solution to meet the customers’ business needs andrequirements

  • Provideonsite or virtual product training to customers as needed

  • Researchand resolve customer questions and issues as a result of testing

  • Assistas necessary in scoping new and existing customer opportunities to ensurethat implementation work effort is estimated appropriately prior tocompleting the sales cycle

  • Coordinateswith Project Management to prepare the Implementation Plans and Statementsof Work that include detailed requirements for the project specific to a customer’sbusiness processes

  • Actas a point of escalation / liaison with client management team to driveissue resolution for clients across the business

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.


  • HighSchool Diploma / GED

  • 2+years of experience / knowledge of the healthcare industry and/or clinicalexperience

  • 2+years of experience with claims processing and/or coding or equivalentimplementation experience

  • Experience in claim submission and processing, billingpractices

  • Medicalcoding certification or able to gain certification in one year

  • Workingknowledge of client - server concepts and relational databases

  • Proficiencyin Microsoft Word and PowerPoint

  • Intermediatelevel of proficiency in MS Excel

  • Abilityto travel up to 25%

  • Employees are required toscreen for symptoms using the ProtectWell mobile app, Interactive VoiceResponse (i.e., entering yoursymptoms via phone system) or a similar UnitedHealth Group approvedsymptom screener prior to entering the work site each day, in order tokeep our work sites safe. Employeesmust comply with any state and local masking orders. In addition, when ina UnitedHealth Group building, employees are expected to wear a mask inareas where physical distancing cannot be attained

  • Youwill be asked to perform this role in an office setting or other companylocation, however, may be required to work from home temporarily due tospace limitations

Preferred Qualifications:

  • BA / BS degree in healthcare or business related field

  • Strongclinical background

  • Strongpresentation skills

  • Backgroundwith participating in the implementation of software

  • Optum Claims Manager or Advanced Communication Engine (ACE) end-userexperience

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care 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 bestwork.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Diversity creates ahealthier atmosphere: UnitedHealth Group is an Equal EmploymentOpportunity/Affirmative Action employer and all qualified applicants willreceive consideration for employment without regard to race, color, religion,sex, age, national origin, protected veteran status, disability status, sexualorientation, gender identity or expression, marital status, geneticinformation, or any other characteristic protected by law.

UnitedHealth Group isa drug-free workplace. Candidates are required to pass a drug test beforebeginning employment.

Job Keywords: Sr. Business Analyst, healthcare, clinical, claims processing, coding, coding certification, Claims Manager, ACE, telecommute