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

About this job

Energize your career with one of Healthcare's fastest growing companies.  


 


You dream of a great career with a great company – where you can make an impact and help people.  We dream of giving you the opportunity to do just this.  And with the incredible growth of our business, it's a dream that definitely can come true. Already one of the world's leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our Service Centers, improve our Service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.


 


This opportunity is with one of our most exciting business areas: Optum –a growing part of our family of companies that make UnitedHealth Group a Fortune 14 leader.


 


Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions, and treatments; helping them to navigate the system, finance their Healthcare needs, and stay on track with their Health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation, and Performance.



 


The Chart Review Project Manager will initiate and lead negotiations with internal and external customers and manage relationships in order to meet Federal regulations requiring Medicare Advantage plans to ensure complete and accurate coding is represented in the submissions to CMS.


 


 


Primary Responsibilities:




  • Influence internal and external customers to facilitate requests to meet client deliverables

  • Project management of chart review initiatives from creation of projects to delivery and completion

  • Improve operational efficiencies through creation and/or changes in current procedures

  • Manage workflow and serve as liaison between internal business partners, external vendors and clients

  • Work with and involve relevant stakeholders (regional and corporate network management, internal customers, external customers, etc.) in negotiation decisions impacting legal or regulatory requirements, and contract standards

  • Monitor geography-specific unit RAF performance and improve competitiveness, breadth, and stability of customer

  • Develop and successfully implement geography-specific retrieval plan

  • Drive relevant components of provider relationship management, including leading meetings, as necessary, and steering of provider outreach/communication

  • Educate internal teams on the process and reporting

  • Design and deliver scalable processes for project request receipt and delivery

  • Set expectations to key stake holders and deliver on requests

  • Manage workflow to balance standard processes against crisis management

  • Develop and maintain target metrics to measure workflow, work product and achieve operational efficiencies

  • Manage ad hoc projects and reports from initiation to completion

  • Prepare historical trend analysis on key metrics and recommend metrics-based performance goals

  • Manage team to research issues and discrepancies by pulling and analyzing the appropriate data

  • Oversee Data Release Governance process for delivering project start files to vendors

Requirements

Required Qualifications:




  • High School Diploma/GED


  • 3+ years of experience managing small to large projects from inception to completion


  • 3+ years of experience working with internal and external customers, clients and vendors


  • 3+ years of  Cross-functional communication experience


  • 1+ year of Microsoft Excel experience (related to manipulation and data analysis)


  • 1+ year of experience creating and designing new processes and systems

 


 


Preferred Qualifications:




  • Bachelor's Degree


  • Experience in the Healthcare industry


  • Experience working with medical claims


  • Experience with Medicare guidelines


  • Experience working with PowerPoint and Access


  • Sales experience


  • Previous management experience

 


 


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 best work.(sm)


 


 


Diversity creates a healthier atmosphere: 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.