Employer & Individual Reimbursement Policy Manager

This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. The Employer & Individual Reimbursement Policy Manager is an Individual contributor role part of our Reimbursement Policy team. As a Payment Policy Creation Manager Reimbursement Policy Manager, you will be empowered to develop and maintain UnitedHealthcare policies, cultivate new project initiatives, monitor and research third party sources to ensure UnitedHealthcare's alignment, ensure implementation of coding and edit updates, and identify potential reimbursement opportunities. This position is full time. Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm. It may be necessary, given the business need, to work occasional overtime. We offer 4 weeks of on-the-job training. The hours of training will be aligned with your schedule.

Manage E&I and IFP professional and facility reimbursement policies. Interfacing with other Reimbursement Policy managers to maintain and support reimbursement policies for UHC and ensure accurate and timely implementation of coding and edit updates. Project Management which includes completing multiple phases as part of reimbursement policy creation and implementation including documentation creation, presentations to large groups, and writing business requirement documents. Analyzing and manipulating large volumes of data. Providing coding and reimbursement policy expertise to UHC departments. Ensuring claims are handled accurately in accordance with reimbursement policies. Review and analysis of third-party publications and resources regarding reimbursement and coding standards. Represent reimbursement policy functions and processes and provide subject matter expertise on any reimbursement policy related initiatives. Create and/or maintain materials owned within the department. Demonstrated ability to work across multifunctional teams. Consistently drive affordability initiatives impacting multiple business segments. Develop innovative approaches that support correct coding and accurate claims editing associated with reimbursement policies. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

High School Diploma / GED Coding Certification through AAPC (Ex: CPC, COC, CIC) or an AHIMA certification. Must be 18 years or older Understanding of Facility and Professional Reimbursement policies. Knowledge of coding methodologies including but not limited to: CPT, HCPCS, ICD-10, and Revenue Codes. Knowledge and experience with CMS (Centers for Medicare and Medicaid Services) manuals and NPFS (National Physician Fee Schedule) Experience with editing tools (iCES and/or CES) in support of professional and facility reimbursement policies. Experience in one or more of the following platforms/applications -UNET, USP/CIRRUS, and/or Facets. Intermediate level of proficiency with PC based software programs including Microsoft Word, Microsoft Excel, and Microsoft Outlook. Ability to work full time. Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm. It may be necessary,