Associate Director of Denials - Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team 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 make 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.

As the Associate Director of Denials you will be responsible for leading the Denials Strategy of our Revenue Cycle Collection team and partnering with external clients. You will be expected to manage impactful KPI's and metrics pertaining to this book of business. You will collaborate externally and internally to provide input to policies, systems, methods, and procedures for the effective management and collection activities. In this role, you will educate customers and partner with internal department regarding issues or concerns in achieving the goals and metrics. This role with be responsible for managing the preparation of reporting to internal partners and external clients on performance updates and actions taken to either maintain or improve performance.

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

Primary Responsibilities:

• Provides leadership for Denials improvement strategies for our RCM Collection efforts
• Help drive process improvements resulting in performance improvement within RCM
• Develop and Implement strategic plans to achieve goals and performance measures through cross function teams(including external client and internal partners)
• Effectively communicate with external client leadership as well as internal SLT
• Build & maintain deep relationships/partnerships with clients to ensure continuous improvement and growth
• Oversee the end-to-end denial management process, including initial denial review, appeals, and root cause analysis
• Lead a team of denial analysts, appeals coordinators, and clinical reviewers
• Develop and monitor KPIs related to denial trends, appeal success rates, and financial impact
• Collaborate with Clinical leaders to ensure clinical documentation supports medical necessity
• Ensure compliance with CMS, Medicaid, and commercial payer guidelines
• Partner with IT and data analytics teams to enhance denial tracking and reporting tools
• Conduct training and education for clinical and revenue cycle staff on denial prevention
• Participate in payer contract reviews and negotiations to address recurring denial issues
• Prepare and present regular reports to executive leadership on denial performance and improvement initiatives

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 experience in Revenue Cycle
• 5+ years of experience supporting a health system
• 2+ years of experience in denials in an ambulatory / acute setting
• Demonstrated experience in navigating and working across multiple departments to develop, communicate, and support a company's short-term and long-term business objectives

Preferred Qualifications:

• Experience working with matrixed leadership
• Experience with practice management systems (i.e. MS4, Invision, EPIC, STAR, eFR)
• Skilled in Denials Management
• Possess personal qualities of integrity, credibility, and commitment to Optum's Vision and Values

*All employees working remotely will be required to adhere to UnitedHealth Group'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 (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 $89,900 to $160,600 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.

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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, 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.

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