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Delegated Credentialing Account Manager - Telecommute

Company: UnitedHealth Group
Location: Miami
Posted on: September 22, 2022

Job Description:

UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing -your life's best work.(sm) You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities:

  • In compliance with the organizations' established methodology, -conduct delegated credentialing audits in accordance with standard operational, regulatory, accreditation and compliance processes and procedures
  • Provides guidance, remediation, and post follow-up outcomes communication to mitigate operational risk of repeat corrective action plans, fines and/or penalties from regulators
  • Manage the end-to-end oversight responsibilities for delegated credentialing
  • Drive consistent and efficient processes to support the management of all delegated credentialing audit activities
  • Analyze and investigate, problem resolution; defining and recommending action items for the delegated group; evaluating outcomes and providing ongoing feedback to appropriate delegate and internal staff/committees; providing support at Regulatory and Accreditation surveys, as needed
  • Communication, flexibility, credibility, and the ability to interpret accreditation and regulatory requirements and delegated entity policies to assure accurate implementation of processes are the key drivers needed in this role to establish and sustain the delegated relationship, learn about their environment and help customers understand United's delegated credentialing model A Day in the Life: Clinical Quality Analyst
    • Log into computer, review daily calendar, and check email/voice messages
    • Prioritize daily work utilizing critical thinking skills
    • Participate in monitoring activities -
    • Provide support and guidance to team members as needed
    • Organize, request, and follow up on audit material to be collected from external stakeholders
    • Perform reviews of delegate's policies, procedures and credentialing files to assure compliance
    • Attend necessary meetings and/or training sessions
    • Attends meetings with provider groups to assess eligibility for participation in the delegated oversight process
    • Actively participate in projects by attending meetings, gathering information, analyzing data and other assigned tasks
    • Share ideas and techniques for best practices with team and leaders 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 experience in credentialing and/or delegation oversight auditing
      • Proficient computer skills - Microsoft Windows, Word, Outlook, Excel & PowerPoint, and Adobe PDF
      • Designated workspace and access to install secure high-speed internet via cable/DSL in home
      • Ability to travel up to 10% of the time
      • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation Preferred Qualifications:
        • Effective written and verbal communications and analytical skills
        • Proven ability to be self-motivated, independently problem solve and apply critical thinking strategies
        • Ability to work autonomously
        • Detail orientated with focus on quality/quality assurance
        • Solid conflict management and negotiation skills
        • Ability to respond quickly to new instructions, situations, methods, and procedures
        • Ability to manage competing demands on time Skills You Will Develop:
          • Assess and interpret customer needs and requirements
          • Identify solutions to non-standard requests and problems
          • Ability to work in ever changing, fast- paced environment while maintaining a flexible approach to managing tasks and fulfilling responsibilities
          • Ability to use constructive criticism/feedback to improve skills and work processes To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment Careers with UnitedHealthcare. -Let's talk about opportunity. Start with a Fortune 5 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do -your life's best work.(sm) Colorado, Connecticut or Nevada Residents Only: -The hourly range for Colorado residents is $26.15 to $46.63. The hourly range for Connecticut / Nevada residents is $28.85 to $51.30. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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. *All Telecommuters will be required to adhere to 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. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: UnitedHealth Group, Miami , Delegated Credentialing Account Manager - Telecommute, Executive , Miami, Florida

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