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in Brentwood, TN

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Hours Full-time, Part-time
Location Brentwood, TN
Brentwood, Tennessee

About this job

Under the guidance of the VP of Operations, the Director Reporting and Business Analyst will provide business and technical consulting services for Medicaid, Long Term Support Services and other operations  business requirements as a result of the TennCare Contractor Risk Agreement mandated by the Bureau of TennCare  for the state of Tennessee

 

Serve as a subject matter expert (SME) working with senior level management to identify impacts, analyze issues and drive solutions for regulatory reporting requirements. Perform business impact assessment, write detail reports and specifications, drive needs into design and support activities such as testing for follow-on application development and system integration.

 

Role requires a strong understanding of Medicaid/Medicare Program business analyst with healthcare (preferably Medicaid) experience.  Conduct business impact assessment, perform gap analysis, and document impacted medical policies and business processes.  To support inter departmental customers the candidate must have extensive knowledge of healthcare business processes in order to perform evaluations of reporting/business requirements. Using past experience you must develop assessment reports, alternative solutions, recommendations and the creation of an implementation roadmap in the initial development phases the candidate will be responsible for documenting functional Reporting documentation to meet the needs of all internal customers.

Requirements

•Undergraduate degree preferred

•More than 5 years' experience in the Medicaid/Medicare business, Healthcare Operations In Medicaid or Healthcare including Long Term Care Operations required

•1+ year of Experience with CPT Coding/ claims operations/ ICD9/ ICD10 required

•3+ years Management experience working with matrix teams required

•Detailed end-to-end process flow understanding of Medicaid claims adjudication and Medicaid encounter submission

•Experience presenting to Senior Management team

•Ability to be creative in solutions, partner with others and drive those solutions to completion on time and on budget

•Must have good communication skills both verbal and written

 


Positions in this function are responsible for end-to-end business process activities - creating, controlling and improving business processes. Leads process design and project implementation teams in process improvement activities. Diagnose process improvement opportunities and develop solutions using principles of process excellence and related tools. This position is also responsible for quality reporting, analysis and audits and for developing plans and programs to support continuous quality improvement using applicable tools. May assist in the creation, implementation, and evaluation of Total Quality Management (TQM) programs. May direct design, facilitation, training and evaluation of TQM incentive programs and may oversee quality improvement projects and teams. Positions that require certification in project management or accredited Six Sigma training should use the Project Management job family.
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.