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Recovery Analyst - Southfield, MI - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Southfield, MI Southfield, Michigan |
About this job
Position Description:
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 Business Operations 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.
Core Competencies:
- Strong writing and documentation skills
- Organizational skills
- Creativity
- Extensive work experience, possibly in multiple functions.
- Work does not usually require established procedures.
- Works independently.
- Mentors others.
- Acts as a resource for others.
- Coordinates others' activities.
Requirements
Requirements:
- High School Diploma/GED
- 1+ year experience with CSP Facets
- 1+ year experience with Medicaid reimbursement
- Proficiency with MS Excel with importing/exporting data, using formulas and pivot tables
Assets:
- Bachelor's degree
- Previous experience using Access databases
- Previous experience using Michigan FACETS
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: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
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