Operations Manager, Payment Integrity - Franklin, TN

Company: UnitedHealth Group ( Learn More )

General Information
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Job Description

If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm)  

The Operations Manager is responsible for selecting, coaching and continuously motivating team members to achieve high levels of performance. The tools the Operations Manager has at hand to measure performance of team members and corresponding client goals include: quality assurance, production reports and statistical data. By using these tools the Operations Manager can successfully address concerns such as: appropriate staffing levels, accurate claims/production, goal(s) alignment, succession planning.


Primary Responsibilities:

  • Maintain a strong working relationship with the corresponding Client Manager in order to ensure a successful partnership for the client and ensure that the Operations Team is aware of client mandates, performance and quality standards, and any changes to the work accomplished on behalf of the client
  • Work collaboratively with Data Analytics to determine priority of inventory. Together, they help assess the quality of inventory to be worked and evaluate the feedback from the Claims Analysts in order to assist the Data Analysts in identifying trends and writing queries
  • Work collaboratively with the Business Excellence department in order to uphold best practices, identify process improvements and maintain (increase) quality and production levels, and identify and answer all training needs
  • Responsible for staff management and administration of multiple functions, or management of general business operations
  • Manage daily operations of multiple levels of staff and multiple functions / departments across one or more business units
  • Manage and will be accountable for professional employees and/or supervisors
  • Perform additional duties and responsible for additional projects as assigned

  • Required Qualifications:

  • Undergraduate degree or equivalent experience (i.e.: 2 - 4 years of healthcare experience)
  • 2 or more years of experience managing daily operations of multiple levels of staff and multiple functions / departments across one or more business units in a large organization
  • 2 or more years of proven ability to produce within a fast paced, matrixed organization with limited direction
  • Intermediate or greater level of proficiency with PC based software programs and automated database management systems (Excel, Word, Outlook, and PowerPoint)
  • Preferred Qualifications:

  • Master's degree or higher level of education
  • 3 or more years of management experience
  • 3 or more years of healthcare experience
  • Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

    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.   

    Job Keywords: Operations Manager, manager, management, payment integrity, healthcare, data analytics, workflow, claims, client mandates, Franklin, TN, Tennessee

    Job Requirements