About The Company
Optum is a global organization dedicated to delivering innovative healthcare solutions through the integration of care and technology. Our mission is to help millions of people live healthier lives by providing access to comprehensive healthcare services, pharmacy benefits, data analytics, and resources that support health optimization. We foster a culture rooted in inclusion, collaboration, and continuous development, offering our employees opportunities to grow their careers while making a meaningful impact on the communities we serve. At Optum, you will be part of a dynamic environment committed to advancing health outcomes on a global scale, guided by our core values of caring, connecting, and growing together.
About The Role
This position is responsible for the installation, administration, and management of assigned healthcare contracts. Key duties include building and setting up contract structures, managing billing configurations, collecting eligibility information, revising structures as needed, researching and resolving structure issues, loading data into various databases, and preparing plan materials such as administrative documents and customer education materials. The role involves ensuring accurate contract loading across different systems, troubleshooting installation issues, and developing customer-specific solutions. Additionally, the position may involve auditing contract loads to ensure compliance with quality standards and reporting requirements.
The role is full-time, Monday through Friday, with standard business hours from 8:00 AM to 5:00 PM PST. Flexibility for occasional overtime or weekend work may be required based on business needs. The position offers on-the-job training aligned with your schedule, providing a comprehensive understanding of healthcare contract management processes. Employees based within the Pacific Time Zone have the flexibility to work remotely, supporting a balanced work environment while tackling complex challenges.
Qualifications
- High School Diploma / GED or equivalent work experience
- Must be 18 years of age or older
- At least 2 years of experience working within the State of California Managed Care environment, including roles in IPA, Physician Office, Hospital Administration, or related healthcare industry
- Experience working with healthcare claims processing and management
- Proficiency with computers and Windows-based programs, including Microsoft Word, Excel, Outlook, and Teams
- Experience with Microsoft SharePoint
- Ability to work full-time during standard business hours (8:00 AM - 5:00 PM PST) with flexibility for occasional overtime or weekends
Responsibilities
- Manage intake processes and assist with project coordination
- Triage provider requests based on their status and urgency
- Communicate effectively with Care Delivery Organizations and healthcare providers
- Process and distribute various contract documents accurately and efficiently
- Train internal teams on system functionalities and updates
- Utilize relevant data and factual information to identify and resolve issues within your area of expertise
- Investigate non-standard requests and complex problems, seeking assistance when necessary
- Prioritize tasks and organize work to meet deadlines without compromising quality
- Provide clear explanations and information to colleagues and clients on contractual topics
- Perform additional tasks as assigned to support team objectives
Benefits
- Competitive hourly pay ranging from $23.70 to $46.35, based on experience and local market conditions
- Comprehensive benefits package including health, dental, and vision coverage
- Incentive and recognition programs to reward performance
- Equity stock purchase options and 401(k) retirement plan contributions
- Opportunities for career growth and professional development
- Flexible remote work options for employees residing within the Pacific Time Zone
Equal Opportunity
Optum is an Equal Employment Opportunity employer. We are committed to creating a diverse and inclusive workplace where all qualified applicants receive consideration regardless of race, national origin, religion, age, gender, sexual orientation, gender identity, disability, veteran status, or any other protected characteristic under applicable law.