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?
TRICARE Benefits Analyst - Eau Claire, WI or San Antonio, TX-315533
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
UnitedHealth Group has submitted a proposal in response to the TriCare Managed Care Support Contract Solicitation (also known as the "T-3 Solicitation"). TriCare is the health care program serving active duty service members, National Guard and Reserve members, retirees, their families, survivors and certain former spouses.
UnitedHealth Military & Veterans Services is part of the family of companies that make UnitedHealth Group one of the leaders across the US health care system.
We serve those who serve our nation, providing quality health care services to millions of military beneficiaries across the South.
Our commitment to helping people live healthier lives, and to continue the honor, satisfaction, and quality of the TRICARE military health benefit program is greater than ever. Our efforts complement the Military Health System to demonstrate the best blend of public and private health care solutions.
It's not just business as usual. It is one of our proudest endeavors.
If you're ready to help make health care work better for those who serve our nation. If you are smart, creative, and committed. If you want to make a difference. Consider being part of the elite team at UnitedHealth Military & Veterans Services.
Position Description:
The Benefits Analyst is responsible for building the product hierarchy for various TRICARE groups and building the detailed benefit plan rules within the COSMOS system. The full implementation requires an understanding of the COSMOS DIV, benefits packages, claim reviews, BPLs, iBAAG templates, notification requirements, service codes and plan specific nuances.
Primary Responsibilities:
- Benefit analysis and configuration
- Benefit testing of configuration and validation that benefits were updated accurately to ensure adherence to quality measures and correct interpretation of TRICARE requirements
- Complete implementation of benefit structures and product hierarchies, including structure building and set up, structure revisions, researching & resolving structure issues and database loading
- Project review and updates
- Participation on conference calls as a subject matter expert for benefits to include COSMOS and iBAAG configuration
- Table updates/responding to email questions/audit findings
Qualifications Qualifications:
- High School diploma or GED is required
- 2 years experience with group benefit structures is required including an understanding of benefit plan structures and cost sharing rules, and the ability to translate benefit provisions into detailed coding structures based on CPT, ICD-9, HCPCS, Revenue codes
- A background in healthcare operations (claims processing, billing and / or enrollment) is preferred
- Experience with COSMOS is preferred
- Basic MS/Office (Word, Excel & Outlook) experience is required
- Need to communicate clearly and professionally
- College Degree is strongly desired
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.
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. |
