Serve as a member of the operations senior leadership team and advise executives on external trends, problems, and activities to facilitate both short and long range strategic plans to improve operational performance and enhance growth. Set the vision and strategic plan for OptumRx PBM operations & client services and support scaled operations through solid partnership ac

This position is to secure the IBMi servers and the applications to prevent unauthorized access to client data, system configurations, application function, communications between servers and applications This position will also help provide evidence for the various audits that take place such as ICFR, SOC, HITRUST and client or state required audits In addition, this pos

Raise the bar on excellence in execution in terms of quality, timeliness, and scalability Take accountability for key engineering metrics of the platform specifically availability, reliability, and security Develop and evolve engineering and product roadmap of UAIS Collaborate across various lines of businesses as well as global locations to ensure smooth execution of cri

Deploy machine learning models and establish automated data pipelines between cloud and on premise environments Design and implement integration and unit tests to ensure system reliability and performance Continuous integration and continuous delivery of production code Develop code and system level documentation Work with the broader technical team to scope engineering m

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 resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, c

Follow established departmental policies, procedures and objectives Notify Provider Enrollment Manager of non compliance issues May involve travel to meet with providers to ensure complete and accurate forms are completed Completion of PIN form for submission to Excellian, track payer data in Symed Follow up on outstanding enrollment issues to ensure timely reimbursement

Read and interpret complex professional provider contracts Conduct Audits in Partnership with the Internal Teams Create reports and analyses using Facets data to validate pre and post configuration changes made by self or others Conducts Configuration Analysis (by reviewing configuration set up and identifying root cause of findings) Collaborate with Claim Ops to Validate

Design and develop onboarding, upskilling, continuing education, and performance improvement training using appropriate mediums (e learning, virtual facilitation, blended learning, job support, etc.) Maintain a high degree of accuracy and attention to detail Follow industry standard design and delivery process model(s) for assigned projects Meet deadlines and effectively

Serves as the clinical liaison with clinical performance and administrative staff as well as providing expertise solving member issues Makes outbound calls to assess members' current health status, as well as take inbound calls to resolve inquiries and assist members as needed. Warm transfer to other departments or services as needed Assesses patient needs using establish

Record monthly journal entries for asset, liability, revenue, and expense transactions Perform monthly account reconciliations for asset and liability accounts Support general ledger close processes including consolidating, maintaining, and reconciling accounts Prepare monthly customer invoices Produce clear, well formed documentation to communicate results and conclusion

Familiarity with SMF/RMF record structures Ability to work with SAS programming and statistical data Utilize knowledge of large scale operational and system concepts Develop and maintain system performance reporting using MXG, SAS, and Splunk Monitor daily system health for areas of improvement and exceptions Deliver recommendations for enhancing performance Perform probl

Prepare or review monthly journal entries for asset, liability, revenue, and expense transactions Perform or review monthly account reconciliations for asset and liability accounts Support general ledger close processes including consolidating, maintaining, and reconciling accounts Produce clear, well formed documentation to communicate results and conclusions Validate fi

Lead engineering teams for conceptualizing, designing, developing, and maintaining vital elements of UAIS Platform Raise the bar on excellence in execution in terms of quality, timeliness, and scalability Take accountability for Key Engineering Metrics of the platform namely Availability, response time metrics, Time to Value and Time to build Develop and Evolve Engineerin

Establish solid market presence as a representative of Optum Financial with payer c suite/VP level contacts Oversee a team that will drive sales activity to build pipeline, proposal, and contract activity to achieve collective team sales quota/target Lead or participate in client meetings delivering solid presentation of Optum Financials' value proposition Manage an organ

Perform financial clearance processes by interviewing patients and collecting and recording all necessary information for pre registration of patients Educate patients of pertinent policies as necessary i.e., Patient Rights, HIPAA information, consents for treatment, visiting hours, etc Verify insurance eligibility and completes automated insurance eligibility verificatio