UnitedHealthcare
At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. EST or CST is preferred.
Required Qualifications: Health insurance environment experience/managed care environment Understanding of the following: Clinical operations Business operations (claims, network, knowledge of credentialing, provider reimbursement) Navigating across departments in the enterprise Intermediate or better proficiency using SharePoint, MS Word, MS Excel and MS PowerPoint Experience creating reports and with technical writing Preferred Qualifications: Licensed registered nurse 5+ years of experience working in a government, healthcare, managed care or health insurance environment Clinical experience Experience with regulatory filings and working with regulators Experience and knowledge working with state level regulators and regulatory agencies Quality management, project management, care management or utilization management experience Knowledge of Mental Health Parity (MHPAEA) state & federal regulatory requirements Demonstrated objective, collaborative approach; relationship builder who strives to build partnerships Demonstrated ability to communicate effectively across multiple departments and with all levels of leadership Demonstrated ability to stay organized and practice effective time management skills Demonstrated ability to work effectively and congenially with employees at all levels Proven ability to manage multiple projects/programs Proven ability to multitask through competing projects/programs
Ensure we are meeting Mental Health Parity requirements Act as a Mental Health Parity (MHP) Subject Matter Expert (SME) monitor, changes to requirements to identify risks Provide MHP training, communication, and education Support the collection of data to analyze compliance Acts as a liaison between teams to coordinate analysis activities Ensure proper reporting and response to internal stakeholders Conduct MHP regulatory research with ability to understand and operationalize state and federal laws, as well as obtain Legal, Compliance, & Regulatory Affairs (LCRA) input as needed Participate in the development of business strategy to meet MHP requirements Facilitate research and respond to internal business partners’ escalated issues, inquiries and questions related to MHP including, but not limited to: Provider reimbursement issues Network adequacy issues Payment Integrity Clinical and operational processes
Basic
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