Claims Business Process Consultant

Claims Business Process Consultant – Letterkenny, Onsite

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.

About the Role:

As a Fortune 5 business, we’re one of the world’s leading healthcare companies. There are no limits here on the resources you’ll have or the challenges you’ll encounter. We have been supporting global healthcare systems from Ireland and the UK for more than 20 years, building a dynamic and diverse team of more than 2,100 talented individuals. With a continued record of growth and stability, we’re on the constant lookout for fresh talent to join our expanding teams. healthcare system works better for everyone.

Working Schedule:

This is a full-time position with standard working hours of Monday to Friday. Occasional after-work hours may be required to support operational needs. This is a full-time position working fully onsite from our Letterkenny office; in order to be considered for this role you must be able to commute to the site reliably from Monday – Friday.

As a Claims Business Process Consultant, you will join the A&H team who are dedicated to delivering support to Operations leaders in M&R and C&S to achieve their short term, medium term and long-term strategic goals. You will work closely with key operations stakeholders to support them with understanding the current and future impacts of automation on operations processes, finances and capacity planning.

Primary Roles & Responsibilities of a Claims Business Process Consultant:

• Evaluate automation ideas
• Quantify automation benefit through the cost benefit analysis process
• Monitor automation delivery schedules
• Monitor automation initiatives delivered, delayed, changes in scope or cancelled
• Monitor automation financial savings forecasts versus actuals
• Identify automation enhancement opportunities though data driven and anecdotal analysis.
• Present periodic updates on automation performance
• Work with automation stakeholders to produce automation performance metrics
• Creation of ad hoc reports in excel or power Bi using SQL

You will 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 providing development for other roles you may be interested in.

Required Qualifications of a Claims Business Process Consultant:

• Degree or equivalent experience
• Experience in USA healthcare
• Proven competency using Microsoft Tools (Word, Excel, PowerPoint)
• Proven ability to lead or develop presentations for stakeholders
• Proven ability to tell a story through data
• Proven ability to manage and self-prioritize workload by anticipating leader’s needs
• Proven ability to organize files and document verbal communications
• Strong proven experience in in working with and monitoring data within the healthcare industry

Preferred Qualifications of a Claims Business Process Consultant:

• Working Knowledge or experience with SQL with the ability to write your own queries
• Dynamic dashboards in Excel/tableau/power bi
• Knowledge of M&R processes both preservice and post service
• Knowledge of C&S both preservice and post service
• Knowledge of DSNP processes both preservice and post service
• Knowledge of Grievance processes

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.

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

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 marginalised 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 employer and all qualified applicants will receive consideration for employment without regard to disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, sexual orientation, or any other characteristic protected by law. UnitedHealth Group is a drug-free workplace. © 2024 UnitedHealth Group. All rights reserved.

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