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Job Information

UnitedHealth Group User Acceptance Tester - Professional Claims in Eau Claire, Wisconsin

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. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life’s best work.(sm)

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

Primary Responsibilities:

  • UAT Testing Team Member

  • Responsible to complete UAT (User Acceptance Testing) test plans and execute test cases for CES application for Medicare & Retirement professional claims

  • Analyze and dissect business requirements, system requirements, technical specifications, and Medicare/CMS policies to create test plans

  • Supports test script development, data preparation, and test execution by planned deadlines

  • Supports and develops automated testing methodologies

  • Prepare group, member and claim data within a test environment

  • Acquire and maintain working knowledge of integrated systems that support COSMOS/CPA and NICE

  • Acquire and maintain working knowledge of integrated systems that support M&R CES

  • Participate in analysis, user stories, sprints, walk-throughs/demos, inspections, code reviews and user group meetings

  • Work with key business stakeholders, business analysts, rule developers, and programmers to identify and remediate defects within CES code and/or core claim platform

  • Maintain a robust regression test bed of physician claims for effective and efficient testing of CES editing

  • Develop and maintain working relationships with individuals across a variety of functional areas

  • Facilitate or assist with group meetings, provide agendas and follow up with meeting minutes

  • Prioritize and balance multiple priorities

  • Identify and actively participate in process improvement opportunities

  • Ability to problem solve including multiple priorities and research conflicting and/or inaccurate data

  • Excellent communication, time / project management, problem solving, organizational, and analytical skills

  • Host and facilitate meetings with team and with business customers

  • Deliver presentations at different levels of the organization

  • Process improvement, workflow, benchmarking and evaluation of business processes

  • Self-motivated and assumes new responsibilities

  • Manages changing priorities and modifies plans as needed

  • Faces challenges with optimism and is innovative in finding solutions

  • This role is Remote Nationwide

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 higher) OR 2+ years of equivalent experience as a Claim Processor/Claim Subject Matter Expert (SME) or similar role

  • 2+ years of functional experience with COSMOS & CPW/CPA applications (understands how claims are adjudicated)

  • 2+ years of experience with Medicare/CMS policies and concepts

  • 2+ years of experience with Medicare and Retirement line of business

  • 1+ year of physician claims processing experience

  • 1+ year of experience with CES functionality and/or purpose

  • 1+ year of experience with MS Office Excel using pivot tables, formula development

  • 1+ year of experience with relational databases and database structures

  • Intermediate level of proficiency with Microsoft Office (Word and PowerPoint)

Preferred Qualifications:

  • UAT testing experience

  • 1+ year of experience with COSMOS project methodology (requirements, design, development, test, and implementation) or Agile or LEAN methodologies

  • NICE Platform claims processing experience

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state, and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers with Optum . Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Colorado, Connecticut, Nevada or New York City Residents Only : The salary range for Colorado residents is $26.15 to $46.63. The salary range for Connecticut / Nevada / New York City residents is $28.85 to $51.30. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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

#RPO, #GREEN

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