This position is National Remote. You'll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.*
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.
The National Recoveries Consultant will be responsible for supporting Class Action, Mass Tort, and complex litigation recovery initiatives involving products, medical devices, or pharmaceuticals that have been identified as harmful or defective. The National Recovery Consultant partners with internal and external legal teams and law firms to facilitate the recovery of healthcare claim payments through settlement opportunities. This position will increasingly support legal teams through data expertise.
This position is full time, Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 7:30 am - 5:00 pm EST. It may be necessary, given the business need, to work occasional overtime.
We offer 8 weeks of paid on-the-job training. The hours of training will be aligned with your schedule.
Primary Responsibilities:
Class Action:
- Notice of Pharmaceutical Settlement received; review settlement terms and filing requirements and prepare summary of case
- Request data from all client data sources, providing case summary, parameters and standard data elements
- Prep necessary communications, reporting, and claim filing
- Upon receipt of payments, prepare financial statements, update reporting
Mass Tort:
- Notice of Tort Action received; review case, terms and participation requirements
- Receive Plaintiff Lists from external law firms and lien resolution groups; prepare member data match and retrieve claim histories
- Review claim histories and build relevant liens to submit for recovery
- Pull data into a standard template for Lien Resolution Program negotiation to occur
- Upon receipt of payments, prepare financial allocation, update reporting
- For states that preclude subrogation, obtain policy language to prove subrogation rights
- Follow up with external law firms and lien resolution groups on aging liens
Litigation Data Analytics & Legal Support:
- Work closely with UHG legal teams, providing support in data collection, analysis, matching for various ongoing litigation efforts
- Participate in the development and implementation of evolving processes and best practices related to legal data requests and recovery operations
- Serve as a subject matter resource for claims, member, and financial data utilized in litigation support activities
- Responsibilities may expand to include additional legal support
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:
- High School Diploma / GED OR equivalent years of experience
- Must be 18 years of age OR older
- 2+ years of experience in interpreting and analyzing large data sets
- Understanding and knowledge of health care claims
- Intermediate level of proficiency with Microsoft Excel (sorting, summing, creating bar graphs, and formulas such as pivot tables and lookups)
- Experience with computers and Windows based programs
- Ability to work any of our full time, 8-hour shifts schedules during our normal business hours of 7:30 am - 5:00 pm EST from Monday - Friday, including the flexibility to work occasional overtime given the business need
Preferred Qualifications:
- 2+ years of experience in claims recovery and resolution, subrogation, litigation support, healthcare operations or a related an operations - based environment
- 2+ years of experience with working in collections, negotiations, mediations, arbitrations, or legal support; preferably in the health insurance industry
- 2+ years of experience in Fraud, Waste, Abuse & Error
- Leadership experience
- Familiarity with SAS, building, and exporting data
- Advanced proficiency with Microsoft Excel (data analysis functions)
- Experience with leveraging tools such as macros or AI to improve operational efficiency
Telecommuting Requirements:
- Ability to keep all company sensitive documents secure (if applicable)
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy
- Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Soft Skills:
- Strong analytical, problem-solving, and critical-thinking skills
- Ability to identify data discrepancies and perform data quality validation
- Excellent written and oral Communication skills
- Attention to detail
*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 $72,800 - $130,000 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.
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.