Sr. Benefits Manager, Individual and Family Plans - Remote

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

Individual and Family Plans (IFP) is a growing business within UnitedHealthcare. The Sr. Benefits Manager, IFP is responsible for managing key IFP Product deliverables, including ensuring benefit information is clear, accurate, consistent, and delivered timely to internal partners. This individual will serve as a subject matter expert on IFP benefits for their respective markets, with responsibility for translating IFP plan designs, regulations and policies (i. e. , Certificates of Coverage) into detailed business requirements, ensuring benefits are implemented accurately and timely, investigating and responding to internal benefit inquiries, and supporting claims testing activities. This role requires a deep understanding of, and experience with, product implementation and configuration processes to ensure our benefits are administered accurately, compliantly and in alignment with our organizational goals. Applicants should be interested in being part of a developing team and enjoy deriving structure and clarity from ambiguous and complex inputs.

This position is not focused on managing software products. The term 'product' in this context refers to health insurance plans and products, specifically individual and family plan products.

You'll enjoy the flexibility to work remotely * from anywhere within the U. S. as you take on some tough challenges.

Primary Responsibilities:

• Supports onboarding, training, developing and engaging with high-performing team members

• Develop and document policies, requirements and relevant background information for other departments to better understand plan designs and benefit intent

• Translate plan design strategies, policies (i. e. , Certificates of Coverage) and regulatory changes into detailed requirements for benefit configuration

• Coordinate with IFP Product team members to ensure accurate, clear, and consistent benefit and configuration requirements across regions

• Manage plans and benefits hand-offs to internal and external partners; develop and manage change control processes

• Partner with Product Management & Regulatory Alignment, operational, clinical, and configuration teams to achieve benefit and configuration design solutions that align with plan design strategy and business requirements

• Serve as the IFP Product lead on claims testing and quality assurance activities for assigned markets, informing test plans and assisting in defect resolution

• Provide subject matter expertise to address escalated benefit inquiries and complex benefit-related issues

• Identify opportunities to improve processes and build best practices for efficient and effective translation of product strategy/plan designs into configuration requirements

• Demonstrate systems thinking to readily identify downstream impacts of decisions

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:

• 5+ years of proven experience in health insurance policy and product/benefit implementation

• Experience working collaboratively across multiple functional areas (e. g. , operations, configuration, claims, clinical, technology), including organizing and leading cross-functional meetings

• Expertise in analyzing, interpreting and translating complex data, regulations, member policy documents, benefit interpretation guidelines and coverage/reimbursement policies into practical, actionable insights and recommendations for implementation

• Proficiency in communicating and documenting business/configuration requirements, benefit content for internal teams and members and supporting documents and other critical information to key stakeholders

• Working knowledge of benefit configuration, processes and tools

• Working knowledge of medical coding (Revenue Codes, HCPCS, CPT, ICD-10)

• Proven ability in efficiently identifying, analyzing, and resolving issues

• Ability to travel for business 2-3 times per year

Preferred Qualifications:

• Medical Coding Certificate: RHIT or CPC by AAPC or AHIMA license

• Experience in working independently, managing time effectively and prioritizing tasks

• Experience interacting and effectively communicating with senior leadership

• Working knowledge of claims processing

• Working knowledge of Affordable Care Act (ACA) market requirements and other regulations

• Intermediate or higher level of proficiency in Microsoft Office applications

• Proven ability to balance strategic thinking with the urgency to drive work forward

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D. C. Residents Only: The salary range for this role is $104,700 to $190,400 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

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 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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment .