Provider Reimbursement Supervisor, Hybrid in El Segundo, CA

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

Positions in this job family are responsible for various financial functions, including financial accounting (statutory/GAAP Accounting), investment, cost accounting, accounts receivable/payable, financial analysis, budgeting, forecasting, financial planning, audit, tax and treasury, and health care economics. This excludes billing, underwriting, actuarial, pricing, and network pricing.

Positions in this function prepares and maintains records of amounts owed and ensures payments are promptly issued. Teammates in this function processes and verifies the validity of expenses, reviews documents for accuracy and compliance with organizational policy and regulatory guidelines, including proper authorization, documentation, general ledger coding, correct amounts, proper remittance, and sales tax (if applicable). This role may include responsibility for vendor and provider payments.

General Job Profile

• Management Accountability: Supervises and is accountable for professional employees. The impact of work is primarily at the local level
• Scope and Guidelines: Provides support to manager as it related to team direction, resolution of issues, supports audit controls, creates process improvements, and provides guidance to team members

Primary Responsibilities:

• Support and Develop:
  • Supervise, mentor, and guide team members to enhance their skills and ensure tasks are effectively and timely completed
  • Act as the first point of escalation, offering guidance to resolving complex issues
  • Support the team so they are independently maintaining critical workflows during absences to avoid any interruptions
• Communication and Responsiveness:
  • Ensure timely and professional communication with internal stakeholders such as finance, procurement, and other departments to prevent unnecessary escalations
  • Foster cross-functional collaboration to resolve issues and streamline processes for improved efficiency
  • Promote clear and consistent communication within the Provider Reimbursement (PR) team, ensuring timely responses to all emails
  • Prioritize updates on missing or late payments, ensuring clear and prompt communication with all relevant parties
• Process and Workflow Management:
  • Assist manager in implementing and maintaining standardized workflows to ensure efficiency and consistency across the team’s processes
  • Provide the necessary training, tools, and system access to cover all aspects of the reimbursement workflow
  • Foster accountability by ensuring team members are responsible for their tasks throughout the entire process
• Professional Conduct:
  • Enforce company policies, ensuring team members, including yourself, refrain from taking PTO during critical processing times
  • Lead by example, making responsible decisions that account for the impact on the team and overall workflow
• Sense of Urgency:
  • Address and resolve issues quickly, maintaining a proactive approach to managing potential problems before they escalate
  • Ensure the timely and accurate payment of vendor and provider invoices, adhering to established deadlines
  • Prioritize communication on missing or late payments, providing prompt and transparent updates
• Process Improvement:
  • Continuously review and refine the accounts payable (AP) processes, identifying and implementing improvements to enhance team efficiency.
  • Standardize operations to streamline processes and improve team productivity
  • Regularly track and analyze AP metrics and KPIs to identify areas for process enhancement
• Compliance:
  • Support the team’s adherence to internal and external policies, procedures, and regulations, so they always maintain full compliance
  • Detect and address potential fraud, utilizing available tools and resources to protect the organization’s financial integrity

 

Functional Competencies

• Supervises the Processing of Compensation for IPA Providers  
  • Audits compensation requests for accuracy and DOA approvals
  • Reviews & processes compensation timely and accurately
  • Processes payor and patient refunds
  • Coordinates with other teams (if necessary) to resolve payment process issues
• Supervises and Maintains Reporting Systems and Data
  • Educates employees and external stakeholders on AP systems and policies (e.g., IDX)
  • Generates standard and ad hoc reports as requested and required
• Ensure Compliance with Applicable Policies, Regulations, and Controls
  • Ensures compliance with applicable AP and expense policies
  • Ensures compliance with applicable internal and external policies, procedures, and regulations (e.g., UHG expense policies, tax authorities, regulatory agencies, and Sarbanes-Oxley regulations) 
  • Ensures compliance with applicable audit control requirements
  • Leverages tools, resources, and available information to detect potential fraud and takes appropriate action

Values-Based Competencies

• Integrity Value: Act Ethically
  • Comply with applicable laws, regulations, and policies
  • Demonstrate integrity
• Compassion Value: Focus on Customers
  • Identify and exceed customer expectations
  • Improve the customer experience
• Relationships Value: Act as a Team Player
  • Collaborate with others
  • Demonstrate diversity awareness
  • Learn and develop
• Relationships Value: Communicate Effectively
  • Influence others
  • Listen actively
  • Speak and write clearly
• Innovation Value: Support Change and Innovation
  • Contribute innovative ideas
  • Work effectively in a changing environment
• Performance Value: Make Fact-Based Decisions
  • Apply business knowledge
  • Use sound judgment
• Performance Value: Deliver Quality Results
  • Drive for results
  • Manage time effectively
  • Produce high-quality work

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:

• Undergraduate degree or equivalent experience
• 3+ years of finance/accounting experience
• Experience working collaboratively and influencing others within a matrix organization
• Proficiency in Microsoft Office (Excel inc. pivot tables, MS Teams, MS Access, and MS Word)
• Proven highly effective verbal and written communication skills for a variety of audiences
• Proven ability to effectively manage multiple priorities

Preferred Qualifications:

• MBA
• Healthcare experience
• Experience using Hyperion Essbase and PeopleSoft Financials
• Proficiency in Athena I.D.X. medical management system
• Proven excellent written communication skills and the ability to verbally communicate ideas clearly & confidently

This updated outline reflects the core duties of the Provider Reimbursement Supervisor, focusing on supervision, process management, communication, and compliance, while supporting the manager through day-to-day operations and team performance.

NOTICE: Other duties and responsibilities not specifically described within this document may be redefined, or reassigned from time to time, consistent with the knowledge, skills, and abilities of the incumbent by management.

The salary range for this role is $71,600 to $140,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.

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

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