Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

• Consistently exhibits behavior and communication skills that demonstrate our company’s commitment to superior customer service, including quality, care and concern with each and every internal and external customer.

• Uses, protects, and discloses our patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.

• Knowledgeable with HMO insurance

• Knowledgeable with DMHC, CMS, DHCS, NCQA

• Solid leadership skills

• Effective communicator

• Performs additional duties as assigned

If you are located in California, you will have the flexibility to work remotely* as you take on some tough challenges.

Primary Responsibilities:

• Assist Managers and Supervisors with escalated issues

• Assist in development of training materials; acts as Subject Matter Expert

• Fields questions and serves as a resource

• Reviews and updates job aids to maximize quality and productivity

• Trend, analyze and improve processes and suggests improvements

• Participate in efficiency and quality improvement initiatives

• Leads or participates in special projects, as required

• Subject Matter Expert (SME): resource for complex issues and process/application questions

• SME: Process/Documents (SOP, JA, Review Guides, Policy, Procedure)

• Analyze, communicate results/trends, and collaborate with leaders to develop action plans for key reports

• Actively participate in key projects and meetings to champion business standardization and flawless execution. Report outcomes to leadership team

• Supervisor and Manager coverage back up

• Facilitate employee engagement activities

• Support and endorses business goals, provide recommendations for improvement

• Excellent interpersonal and motivational skills

• Excellent Problem Solving and analytical skills

• Able to work independently and make sound decisions in a fast-paced environment

• Provide input into the Common Review process when applicable

• Mentoring, coaching, staff education: time management, skill, processes, professional development, etc

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.

Required Qualifications :

• CA nursing license (unrestricted)

• 2+ years of Utilization management experience

• 2+ years of experience as a Manager

• Working knowledge of Microsoft applications (Word, Excel, PowerPoint)

• Knowledge of medical billing and office automation software

• Computer Literate

• Proven excellent verbal and written communication skills

• Proven interviewing and interpersonal skills

Preferred Qualifications:

• Bachelor's degree from a four-year college and/or a professional certification requiring formal education beyond a two year college

• Master's Degree, MBA

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

California Residents Only: The salary range for this role is $104,700 to $190,400 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

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.