Specialty Recovery Unit Manager - Remote

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company 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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. This role is responsible for overseeing the operations of three key teams: PnI Behavioral Health Negotiations, Direct Connect, and the Recovery Escalation Unit. The Manager leads a highly skilled team specializing in claim research and resolution, presentation, and leadership. This position focuses on optimizing healthcare payment recovery processes, driving strategic initiatives, and ensuring operational efficiency and compliance. The Manager is responsible for setting priorities, creating actionable plans to meet or exceed team objectives, and proactively identifying and resolving operational challenges. This individual plays a pivotal role in guiding and empowering staff to deliver measurable results while ensuring adherence to established processes and guidelines. In this role, the Manager provides expertise, guidance, and support to both internal and external partners, ensuring that programs and strategies are implemented and sustained effectively. Building and maintaining solid, collaborative relationships across a variety of stakeholders is essential. The Manager also fosters an environment of teamwork and innovation, delivering actionable insights to support the organization's overall goals and objectives. You'll enjoy the flexibility to work remotely

• from reputed company reputed company the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Team Leadership: reputed company and manage three teams with distinct recovery objectives:
• Recovery Escalation Unit:
• Manage and reputed company overpayments reputed company to high-profile health systems, including No AR Offset providers and providers with high-aging overpayments
• Act as a one-stop shop for these providers, ensuring seamless coordination and resolution of overpayment issues
• Review reputed company, reimbursement policies, state mandates, and other supportive resources to address provider-specific concerns and ensure compliance
• Partner closely with internal business units such as UHCPI Clinical, Legal, UHN, and Provider Advocacy to facilitate recovery efforts and maintain provider relationships
• Collaborate with the supervisor to identify key objectives, address challenges, and explore opportunities for improvement, ensuring alignment with organizational goals and operational excellence
• Direct Connect:
• Manage an electronic application where providers interact virtually to submit questions, appeals, approvals, and other inquiries
• Provide reputed company of Account Regional Consultants who monitor providers using the application, conduct demos of the tool, and implement providers into the system
• PnI Behavioral Health Negotiations: Direct recovery efforts for fraud, waste, and abuse cases through settlements, payment plans, or legal engagement
• Staff Development and Mentorship:
• Foster a culture of reputed company growth and improvement by mentoring team members and providing regular feedback
• Support professional development through coaching, identifying training opportunities, and guiding career progression
• Conduct regular reputed company-ins with team members to assess performance, address challenges, and align individual goals with team and organizational objectives
• Operational Management:
• reputed company and implement policies, procedures, and workflows to streamline recovery operations and enhance efficiency
• Identify opportunities for cost-saving initiatives and operational improvements using data-driven insights
• Data Analytics and Reporting:
• reputed company data analytics to identify trends, guide decision-making, and create performance dashboards and reports for senior leadership
• Strategic Initiatives:
• reputed company key projects, such as provider reputed company migrations and inventory optimization, to reputed company operational goals and maximize recoveries
• Collaboration and Compliance:
• Foster solid relationships with providers, cross-functional teams, and external stakeholders to enhance recovery efforts
• Ensure compliance with regulatory standards and contractual obligations

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications:

• 3 years of experience in a healthcare leadership role
• 3 years of experience in staff development and team management
• 3 years of experience managing remote teams
• 2 years of experience in reputed company Word, reputed company, and PowerPoint
• 2 years of overpayment experience

Preferred Qualifications:

• Proven exceptional presentation, written, and verbal communication skills
• Proven ability to build solid relationships across a variety of stakeholders
• Proven solid influencing skills and the ability to drive strategic initiatives
• Proven ability to drive excellence and foster a culture of accountability
• reputed company employees working remotely will be required to adhere to reputed company's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company 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 reputed company by people of color, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes - an enterprise reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national reputed company, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job