Risk Management Eligibility Analyst, E&I

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

The Risk Management Eligibility Analyst for Employer and Individual conducts Eligibility Verification audits on in-force groups to ensure the group continues to meet the definition of a small employer as defined by their benefit contract. Audits performed verify both group and member level eligibility, participation, and consider factors including group and individual risk, common ownership, PEO, and business segment.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities:

• Conduct eligibility verification audits and reconcile tax documents for group and member level eligibility
• Communicate regularly to build and maintain solid relationships with RAE, inside sales, financial underwriters, customer service, and agents regarding case status and audit related issues
• Communicate decisions/analysis in a concise professional manner that non-auditing personnel will understand
• Interpret Group Policies, COCs, legislative and compliance regulations
• Maintain reporting and tracking database for assigned groups
• Be able to meet turnaround time and productivity goals set by management
• Maintain current knowledge and understanding of HIPAA and PHI regulations
• Takes initiative to identify and resolve issues

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:

• 1+ years of experience in insurance or healthcare and/or auditing, underwriting, enrollment
• Experience meeting turnaround time and productivity goals set by management through prioritizing, organizing and utilizing good time management skills in a fast-paced environment
• Knowledge of insurance industry and products
• Intermediate level of proficiency with Microsoft Office applications
• Proven solid analytical, problem solving and critical decision-making skills

Preferred Qualifications:

• Experience working both independently and in a team
• Knowledge of Tax Documents in an audit setting
• Knowledge of Small Business Insurance requirements
• Understands how the risk management function supports the company's goals, mission statement, and strategic objectives, and recognizes how other departments interrelate
• Knowledge and understanding of HIPAA, ACA, PHI, and PII regulation
• Proven solid verbal and written communication and customer service skills
• Demonstrated ability to exhibit solid attention to detail

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $48,700 to $87,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

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