UnitedHealth Group Hiring for Policy Maintenance Manager – Dublin or Letterkenny Job at Letterkenny , Ireland Full Time

Policy Maintenance Manager – Dublin OR Letterkenny (Remote)

Here at Optum, part of United Health Group we’ll put you in the driver’s seat on vital projects that have strategic importance to our mission of helping people lead healthier lives. Yes, we share a mission that inspires. We need your organizational talents and business discipline to help fuel ours. It’s the opportunity to do your life’s best work.(sm)

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life’s best work.SM

Our claims operations, including our Senior Claims Business Process Consultants, are the focal point of handling information about services patients receive and the way those services get paid. It’s complex, detailed work. It’s fast paced challenge. It’s a job that calls on you to be thoughtful, resourceful, team-driven and customer-focused. To put it mildly, there is never a dull moment.

The Policy Manager will maintain UnitedHealthcare reimbursement policies, monitor and research third party sources to ensure UnitedHealthcare’s alignment, ensure implementation of coding and edit updates, identify potential reimbursement opportunities, and respond to issues and queries around reimbursement policies and edits. This position works within a virtual team. It is a job that requires a person to be thoughtful, resourceful, team-driven, and customer-focused. The position requires the ability to work independently in addition to coordinating with others on the team, as well as those outside of the team.

Responsibilities include, but are not limited to:

• Responsible for maintaining correct coding standards that drive affordability opportunities.
• Researching and documenting the impact of new, changed, and deleted codes for UHC reimbursement policies. This includes performing quarterly code reviews to ensure they are aligned with the reimbursement policies and edits.
• Review and analyze third party publications and resources regarding reimbursement and coding standards.
• Researching and identifying opportunities for new reimbursement policy and editing opportunities.
• Represent reimbursement policy functions and processes and provide subject matter expertise on any reimbursement policy related initiatives.
• Interfacing with other Reimbursement Policy Managers to maintain and support reimbursement policies for UnitedHealthcare and ensure accurate and timely implementation of coding and edit updates.
• Respond to issues and queries around reimbursement policies and edits ensuring claims are handled in accordance with reimbursement policy.
• Create and/or maintain materials owned/maintained within the department.

Qualifications:

• Experience in US Healthcare including claims, contracting or reimbursement.
• Experience and expert knowledge with physician and/or facility reimbursement policies and coding methodologies including but not limited to CPT, HCPCS, and ICD-10.
• Knowledge and experience with CMS (Centers for Medicare and Medicaid Services) manuals and NPFS (National Physician Fee Schedule).
• Certified coder via AHIMA or AAPC or willing to get certified
• Experience in one or more of the following platforms/applications – UNET/TOPS, USP/CIRRUS, COSMOS, Facets
• Experience with Clinical Editing tools (iCES and/or CES) in support of professional and facility reimbursement policies.
• years’ experience working independently in a remove environment.
• Experience with presentations, facilitating virtual meetings, documentation creation and note taking.
• Must be able to communicate effectively including clear and concise verbal and written communication.
• Must be able to work in a fast-paced team-oriented environment.
• Must be able to perform most tasks with minimal supervision.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.

Please note you must currently be eligible to work and remain indefinitely without any restrictions in the country to which you are making an application. Proof will be required to support your application.

“UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.”

Technology Careers with Optum. Information and technology have amazing power to transform the health care industry and improve people’s lives. This is where it’s happening. This is where you’ll help solve the problems that have never been solved. We’re freeing information so it can be used safely and securely wherever it’s needed. We’re creating the very best ideas that can most easily be put into action to help our clients improve the quality of care and lower costs for millions. This is where the best and the brightest work together to make positive change a reality. This is the place to do your life’s best work.(sm)

All telecommuters will be required to adhere to the UnitedHealth Group’s Telecommuter Policy

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer 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.