Expedited Supervisor Appeals - Cypress, CA - Full-time / Part-time

Position Description:
Join
a team of the best and brightest to find bold new ways to proactively
improve the health and quality of our member’s lives! You will find a
wealth of dynamic opportunities to grow and develop as we work together
to heal and strengthen our health care system.
 
The role of an M&R Appeals Supervisor
is to serve as a trusted leadership resource in providing problem
resolution and support for our Medicare members regarding their complex
appeals.  This position is demanding but rewarding as it requires you to
be a self-starter with strong leadership and multi-tasking skills as
well as to be improvement and deadline driven. 
 
Primary Responsibilities:
Responsible for superior Star Rating compliance for timeliness and fairness Monitor staff and inventory to ensure compliance with procedures and internal regulatory time frames Lead projects as needed to improve departmental performanceProvide management with daily reporting on team level compliancePartner with Workforce Management and Appeals leadership to ensure proper staffing and  prioritize daily/weekly team workloadMaintain time and attendance functions/approvals and manage UPTO to UHC policies and proceduresReviewing all Quality defects findings on regular
basis, as well as perform random or focused quality checks as needed to
improve individual and departmental overall quality metricsManage team and individual performance results and provide proper coaching on performance feedback on a regular basisSupport team with appeals processing questions/concernsBuild strong relationships with business partners and departmental leadership team Work as a member advocate to focus on process improvement to identify inefficiencies and member abrasionManage to the VEPS model to exceed goals on areas such as productivity, utilization, efficiency Be a strong and engaged representative of the Part C Appeals Team in meetingsEnhance team morale and drive engagement within team/department Guide team/department through passing CMS and internal auditsOther functions as delegated by management

Requirements:

High School Diploma or GED 1+ years of experience in a Team Lead and/or
Supervisory roleWorking knowledge of A&G processAbility to send emails out of MS OutlookAbility to interrupt and analyze date data off MS Excel worksheetsAbility to create and read MS Word documentsWorking hours between 8:30 am to 6:00 pm Monday through Friday
with additional hours as business needs arise (schedule subject to change)

Assets:

Associate's Degree or higherClaims experienceNICE, COSMOS, STARS, IDT, GPS, iLEAD or similar system
experienceMedicare Part C Chapter 13 fluency

Soft Skills:
Must have strong written and verbal communication skillsProven track record with coaching at an individual and team level resulting in improved performanceCareers with UnitedHealthcare.
Let's talk about opportunity. Start with a Fortune 14 organization
that's serving more than 85 million people already and building the
industry's singular reputation for bold ideas and impeccable execution.
Now, add your energy, your passion for excellence, your near-obsession
with driving change for the better. Get the picture? UnitedHealthcare is
serving employers and individuals, states and communities, military
families and veterans where ever they're found across the globe. We
bring them the resources of an industry leader and a commitment to
improve their lives that's second to none. This is no small opportunity.
It's where you can do your life's best work.

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.