Shire Jobs

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

Primary Responsibilities:

• Peak season

• Planning out all the peak season readiness tracking

• Make sure the risks are called out

• Track the key deployments for milestones

• Making sure the weekly status sent out for all the stakeholders

• Eligibility Issues

• Remove the gaps in eligibility - 50+ issues now

• Work on the Access to care from business meetings – work with IT to get these addressed, not every observations needs to be discussed till IT, this needs to be handled with business

• Work with USP IT for collaboration (Work with IT partners like Cirrus, NIMBUS etc.)

• Claim Routing

• Make sure the impact of claim routing is functioning right

• Map for 11/1, 1/1 and 3/1 claims

• Process of business and USP IT discussions for claims

• Track on QC issues and impact for us in the peak season

• Work with USP IT for collaboration (Work with IT partners like Cirrus, NIMBUS etc.)

• ITSM activities

• All the ITSM preparation (war rooms, DLs, Assessments, risks, process, change tickets)

• Incident management adoptions by VBF

• Supply chain management

• CHG process management

• Broader communications with business

• Daily status and OPS call to Leadership

• War room monitoring and on

• Ops coverage

• On call team for all L1

• Workbook/contact list for each of P1/P2 so that these resources can reach out to L2 as needed

• Validate the ESOCs triggering or Alerts triggering on daily basis

• Monitoring of all the P1/P2 applications

• Daily reporting on application health

• Proactive war room creation

• Working with TCC as per the need

• PGAs

• Track all the surest PGAs for business and IT collaboration

• Attending QRT for impacts

• Collaborations with IT

• Status calls with Mike S/Leadership

• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Required Qualifications:

• Undergraduate degree or equivalent experience

• Healthcare knowledge for more than 10 years

• Production support experience for 8+ years

• ITSM Activities within Optum

• JAVA experience

• Proven solid Project management

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.