Specialty Recovery Unit Manager - Remote

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

This role is responsible for overseeing the operations of three key teams: PnI Behavioral Health Negotiations, Direct Connect, and the Recovery Escalation Unit. The Manager leads a highly skilled team specializing in claim research and resolution, presentation, and leadership. This position focuses on optimizing healthcare payment recovery processes, driving strategic initiatives, and ensuring operational efficiency and compliance.

The Manager is responsible for setting priorities, creating actionable plans to meet or exceed team objectives, and proactively identifying and resolving operational challenges. This individual plays a pivotal role in guiding and empowering staff to deliver measurable results while ensuring adherence to established processes and guidelines.

In this role, the Manager provides expertise, guidance, and support to both internal and external partners, ensuring that programs and strategies are implemented and sustained effectively. Building and maintaining solid, collaborative relationships across a variety of stakeholders is essential. The Manager also fosters an environment of teamwork and innovation, delivering actionable insights to support the organization's overall goals and objectives.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Team Leadership: Oversee and manage three teams with distinct recovery objectives:
  • Recovery Escalation Unit:
    • Manage and oversee overpayments related to high-profile health systems, including No AR Offset providers and providers with high-aging overpayments
    • Act as a one-stop shop for these providers, ensuring seamless coordination and resolution of overpayment issues
    • Review contracts, reimbursement policies, state mandates, and other supportive resources to address provider-specific concerns and ensure compliance
    • Partner closely with internal business units such as UHCPI Clinical, Legal, UHN, and Provider Advocacy to facilitate recovery efforts and maintain provider relationships
    • Collaborate with the supervisor to identify key objectives, address challenges, and explore opportunities for improvement, ensuring alignment with organizational goals and operational excellence
  • Direct Connect:
    • Manage an electronic application where providers interact virtually to submit questions, appeals, approvals, and other inquiries
    • Provide oversight of Account Regional Consultants who monitor providers using the application, conduct demos of the tool, and implement providers into the system
  • PnI Behavioral Health Negotiations: Direct recovery efforts for fraud, waste, and abuse cases through settlements, payment plans, or legal engagement
• Staff Development and Mentorship:
  • Foster a culture of continuous growth and improvement by mentoring team members and providing regular feedback
  • Support professional development through coaching, identifying training opportunities, and guiding career progression
  • Conduct regular check-ins with team members to assess performance, address challenges, and align individual goals with team and organizational objectives
• Operational Management:
  • Develop and implement policies, procedures, and workflows to streamline recovery operations and enhance efficiency
  • Identify opportunities for cost-saving initiatives and operational improvements using data-driven insights
• Data Analytics and Reporting:
  • Leverage data analytics to identify trends, guide decision-making, and create performance dashboards and reports for senior leadership
• Strategic Initiatives:
  • Lead key projects, such as provider interface migrations and inventory optimization, to achieve operational goals and maximize recoveries
• Collaboration and Compliance:
  • Foster solid relationships with providers, cross-functional teams, and external stakeholders to enhance recovery efforts
  • Ensure compliance with regulatory standards and contractual obligations

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:

• 3+ years of experience in a healthcare leadership role
• 3+ years of experience in staff development and team management
• 3+ years of experience managing remote teams
• 2+ years of experience in Microsoft Word, Excel, and PowerPoint
• 2+ years of overpayment experience

Preferred Qualifications:

• Proven exceptional presentation, written, and verbal communication skills
• Proven ability to build solid relationships across a variety of stakeholders
• Proven solid influencing skills and the ability to drive strategic initiatives
• Proven ability to drive excellence and foster a culture of accountability

*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 $89,900 to $160,600 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.