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Appeal and Grievance Manager - Cypress, CA-316001: UnitedHealth Group

Job ID316001
Company NameUnitedHealth Group
Job CategoryLegal; Healthcare
LocationCypress, CA
Position TypeFull-Time, Employee
Experience2-5 Years Experience
Date PostedNovember 9, 2009 (Reposted Dec 29)
UnitedHealth Group
View UnitedHealth Group profile and job listings


Job Category:
Claims

Reference Code:
316001

Position Type:
Full-time, Regular
UnitedHealth Group is among the most ambitious Fortune 25 companies you'll ever meet. Through our family of businesses, we're working to make the health care system perform better for more people, in more ways than ever.

Simply put, we think the entire system can be greater than it's ever been. And that drives us to work harder, aim higher, and expect more from one another.

Here, you'll be empowered to make an immediate impact for millions of others. And you'll achieve more than you ever expected. How does that fit with your plans?

Appeal and Grievance Manager - Cypress, CA-316001

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.

Description

Ovations is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
Imagine joining a group of professionals and clinicians who are working to improve health care for people over 50. Consider the influence you can have on the quality of care for millions of people. Now, enhance that success with enthusiasm you can really feel.
That's how it is at Ovations. Everyday, we're collaborating to improve the health and well being of the fastest growing segment of our nation's population. And we're doing it with an intense amount of dedication.
Position Description:
Positions in this function are responsible for providing expertise or general support to teams in reviewing, researching, investigating, negotiating and resolving all types of appeals and grievances. Communicates with appropriate parties regarding appeals and grievance issues, implications and decisions. Analyzes and identifies trends for all appeals and grievances. May research and resolve written Centers for Medicaid and Medicare (CMS) complaints and complex or multi-issue member/provider complaints submitted by consumers and physicians/providers.
Here, you will discover a culture that grows through challenge. That evolves by being flexible. That succeeds by staying true to our mission to make health care work effectively and efficiently for seniors. Put your best to work for us, and discover extraordinary opportunities for growth.

Qualifications

Requirements:
  • 3+ years experience in a Manager role in the healthcare field
  • Experience managing a staff of 30+ including supervisory level
  • 1 + years of Appeals & Grievance experience
  • Advanced experience using Excel and Access
  • High School diploma or equivalent
Assets:
  • Experience with Medicare claims
  • Experience managing remote staff
  • Project management experience
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace. All candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.




Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.



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