AmeriChoice is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.

If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at AmeriChoice.

We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.

This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.

• This position will review, interpret, and load provider contracts into the Diamond claims payment platform to support AmeriChoice business.
• Work with other departments to clarify contract intent and payment methodologies.
• Interface with cross functional teams and lead large projects.
• Conduct and manage outcomes of various studies that may include analyzing, reviewing, designing, and documenting configuration solutions.
• Develop, analyze, and monitor new, routine, and ad hoc reports using standard database tools.
• Evaluate, interpret and analyze data, configuration options, and/or business processes.
• Collect, analyze and document business requirements for cross functional projects.
• Lead and coordinate configuration teams in cross functional project and achieve timely and accurate deliveries.
• Recommend, implement, document, evaluate and/or maintain policies, procedures and controls.
• May lead and manage operational teams to achieve timely and accurate execution of contract load activities
• May lead and/or mentor associates
• May develop company/department strategic business plans and/or action plans including identifications of objectives, goals and strategies.
• MS Access, Excel pivot tables and SQL skills to design and develop data queries and analysis: 3 years
• Ability to work independently

You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.

Qualifications:

• 5+ year's cumulative experience on all of the following skills: Interpreting Benefits, Loading Provider Contracts, Authorizations and Claims Rules.
• 5+yrs minimum working knowledge of a major claim processing system, such as Diamond or Facets.
• 3+ yrs minimum experience in at least one of the following: MS Access, Excel pivot tables or SQL (at least one)

• PMP certification
• Six Sigma certification
• Knowledge of standard Healthcare payment methodologies

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.