Risk Adjustment Account Manger - Telecommute

UnitedHealth Group - San Antonio, TX - The Risk Adjustment Account Manager is the "Service Owner" responsible for the Care Delivery Organizations' integration to and total service experience of the Risk Adjustment Platform. The principal focus is to serve as the key liaison between the Care Delivery Organizations and the WellMed teams. This position will consult on the development, specification and integration to the WellMed's enterprise systems, analyze business needs, consult on document requirements, monitor andor resolve issues, educate the customer and aid in the optimization their Risk Adjustment line of business. You'll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities Lead, direct and conduct client meetings to identify, determine root cause, monitor and resolve issues Oversees and manages workflow sessions with external customers to capture current state, then utilizing business knowledge and service requests to create and execute future state documentation and processes Document, create and update process flows, documentation and diagrams Performs a role in the development and implementation of major systems. This role may interface with multiple business units such as accounting finance, claims, operations, physician clinics, membership, information technology, and executive management Functions as a liaison between the technical team and business customer, to translate business needs into technical requirements and technical responses into business language Develops and maintains strong relationships with both internalexternals customers at the senior management and executive level in order to influence project teams and gain consensus on the selection of the most viable solutions Educate and consult with the customer on risk adjustment services to include by not limited to DataRAP, Provider Portal, Attestation Delivery, etc. Expand customer expertise and reliance on risk adjustment and reporting to drive usage and adoption Subject matter expert for the Risk Adjustment Platform Receive, triage, and route escalated customer issues to proper internal team for resolution Collaborate with dedicated functional experts to resolve issues quickly and effectively Build and sustain positive relationships with customers through direct and indirect communication Uses strong critical thinking skills along with managed care, or physician office business knowledge to have insight and understanding of business concepts, tools and processes that are needed for making sound decisions in the contact of the company's business Collaborates on and oversees various projects as assigned that are cross-functional in nature Performs all other related duties as assigned 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 Bachelor's degree in Computer Science, Information Systems, Healthcare Administration, Business Management or related businesshealthcaretechnical field required. (Four additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelor's degree) 1+ years of account management experience in the healthcare or insurance industry with medical or ancillary benefits 2+ years leading andor facilitating external client status update calls, where issues will be identified and tracked Experience managing workflow sessions with external customers to capture current state, then utilizing business knowledge and service requests to create and execute future state documentation and processes Must have previous experience create and update process flows, documentation and diagrams One to Three years of experience in major systems implementation experience Experience with various system development lifecycles such as waterfall, RUP, and Agile methods Preferred Qualifications Advanced degree in a related discipline Extensive knowledge of Health Care Industry and related business functions Project Management Certification and or Six Sigma Black Belt Experience Experience in one or more of the following areas systems design, practice management system implementation and support, EMR system implementation and support, Claim adjudication system implementation and support, Care Management system implementation and support Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 240,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm) OptumCare is committed to creating an environment where physicians focus on what they do best care for their patients. To do so, OptumCare provides administrative and business support services to both owned and affiliated medical practices which are part of OptumCare. Each medical practice part and their physician employees have complete authority with regards to all medical decision-making and patient care. OptumCare's support services do not interfere with or control the practice of medicine by the medical practices or any of their physicians. For more information on our Internal Job Posting Policy, click here httpshub.uhg.compolicieshuman-capitalhiring-employmentInternal-Job-Posting208 . Diversity creates a healthier atmosphere OptumCare is an Equal Employment OpportunityAffirmative Action employers 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. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment Job Keywords Business Systems Analyst, San Antonio, TX, Texas... - Permanent - Full-time

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