Risk Management Eligibility Analyst, E&I

Caring. Connecting. Growing Together.

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.

The Risk Management Eligibility Analyst for Employer and Individual conducts Eligibility Verification audits on in-force groups to ensure the group continues to meet the definition of a small employer as defined by their benefit contract. Audits performed verify both group and member level eligibility, participation, and consider factors including group and individual risk, common ownership, PEO, and business segment.

You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities :

• Conduct eligibility verification audits and reconcile tax documents for group and member level eligibility
• Communicate regularly to build and maintain solid relationships with RAE, inside sales, financial underwriters, customer service, and agents regarding case status and audit related issues
• Communicate decisions / analysis in a concise professional manner that non-auditing personnel will understand
• Interpret Group Policies, COCs, legislative and compliance regulations
• Maintain reporting and tracking database for assigned groups
• Be able to meet turnaround time and productivity goals set by management
• Maintain current knowledge and understanding of HIPAA and PHI regulations
• Takes initiative to identify and resolve issues

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 :

Preferred Qualifications :

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 (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $48,700 to $87,000 annually based on full-time employment. We comply with all 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.