Manager, Claims

NAMM California
February 8, 2016

NAMM California (North American Medical Management, California, Inc.) partnered with OptumHealth/UnitedHealth Group in 2012. They share a common goal of bringing patients, physicians, hospitals, and payers closer together in the mission to increase the quality, efficiency and affordability of care.  NAMM CA has the following opening:

Manager, Claims
Req. #633513

You'll join a high caliber team where you're assisting, educating, problem-solving and resolving tenuous situations to the best possible outcomes. Bring your people skills, emotional strength and attention to detail. In return we offer the latest tools and most intensive training program in the industry. Get ready to start doing your life's best work.(sm) 

The Claims Manager is responsible for management and administration of multiple functions, or management of general business operations within Claims Department.

Primary Responsibilities:

  • Oversee daily operations of multiple levels of staff and multiple functions across one or more business units
  • Manage day to day site operations, supervisor leadership (internal and external to organization), and accountability for financial and non-financial results (budgets and actuals)
  • Provide expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims
  • Authorize the appropriate payment or refers claims to investigators for further review
  • Conduct data entry and re-work; analyzes and identifies trends and provides reports as necessary
  • Lead project management and implementation initiatives
  • Oversees Health Plan Audits by providing direction & oversight of scheduling, communication, research, results and any corrective actions responses
  • Assists in Regulatory Audits in addition to any Regulatory reporting requirements

Learn more and apply at  https://careers.unitedhealthgroup.com/data/jobs/claims/633513-manager-medical-claims-ontario-ca

Direct any questions to Allison Keeton, Sr. Recruiter, UnitedHealth Group at allison_keeton@uhg.com

All qualified applicants are considered without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, or any other characteristic protected by law. Candidates are required to pass a drug test before beginning employment.