Develop and execute Internal Audit department operations, methodology, technologies and tools, and continuous improvement efforts in alignment with direction provided by the OSCaR Leader, IAAS leadership, IIA audit standards, the Internal / External Audit Policy and the Charter of the UHG Board of Directors Audit Committee Ensure policies, procedures, and other core depar

Manage administrative tasks for the Complex CARE clinical team Handle outbound calls to members and providers Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers Check verification of eligibility for members as well as benefit information via various internal websites and applications Check discharge

The preparation of quarterly and annual income tax provisions The timely and accurate preparation of federal and state income tax returns and quarterly estimates Assist with the IRS examination Assisting Tax leadership with M & A and other related projects Providing research support for the analysis of proposed and existing tax laws, regulations, and rulings Prepare and r

Works to ensure that internal processes are executed, especially related to intersegment responsibilities, for fraud, waste, and abuse (FWA) vendors' instances of health care FWA by medical profession or insured member Acts as FWA subject matter expert for Federal and local FWA regulations and subsequent regulatory policy and process implementation Keeping apprised of cur

Provide an exceptional customer service experience when responding to and resolving customer service inquires and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims, financial spending accounts and correspondence Research complex issues (such as Medical, Dental, Flex Spending, Pharmacy, etc.) across multiple da

Investigations Refine investigation protocols, documentation standards, and policy interpretation guidelines in partnership with Employment Law and ER Case Management leadership Conduct thorough, timely, objective, efficient and equitable investigations into employee complaints and allegations of misconduct, in line with agreed upon investigation framework and applicable

Develop, lead and execute category management, sourcing/RFx, vendor management and financial analysis efforts across the Enterprise in human capital, legal services and other indirect spend categories as assigned Review, develop, redline, and negotiate complex third party vendor contracts, including Master Services Agreements (MSAs), Statements of Work (SOWs), Non Disclos

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 diversity and inclusion, talented peers, c

Serve as business counsel for the Optum Technology organization Provide legal support for transactional matters, such as software licenses, cloud computing arrangements, collaboration and joint development agreements, supply agreements, equipment purchase and lease agreements, mobile app development agreements, offshore sourcing arrangements, and IT services agreements Ne

Support network pricing strategies and tactics, in collaboration with local network field leaders and network managers Analyze financial impact of provider contracts (e.g., facility; physician; ancillary) Analyze payment appendices to provide options for various contracting approaches and methodologies Communicate results of financial impact and analysis to appropriate st

Provide day to day paralegal and legal services support including leading or assisting on special projects from the Legal Team Work closely with Legal, Quality Management and Regulatory Affairs (QMRA), Compliance and other cross business and functional stakeholders on activities related to enterprise wide regulatory and quality management systems, including coordination,

Deliver technical immigration case consultations, provide guidance and education on GMIT best practices and policies to internal stakeholders Provide consultative guidance including assessing visa eligibility. Partner with immigration counsel to provide immediate and long term strategic case recommendations Partner with managers, talent acquisition, people business partne

Advise UnitedHealthcare's Medicare Part D business Counsel on Part D product, clinical (Pharmaceutical & Therapeutic Committee, formulary development), marketing, and regulatory requirements Provide strategic counsel to the business on the Pharmacy Benefit Management (PBM) Agreements, benefit implementation and management, and compliance oversight and monitoring Provide c

Apply clinical knowledge to Case Managers behavioral health reviews to enrollee's identified as needing or receiving behavioral health services Conduct behavioral health consults with Case Managers, daily and maintain a quarterly schedule for identified members needing or receiving behavioral health services Serve as member advocate by addressing stigma, following Guiding

Test Data Provision & Masking Operation Test data need & masking analysis ( Data structure, SQL queries) Working with Informatica tool to configure & invoke Data Copy and Masking jobs and maintain Gold Copy Maintenance of TDM Portal using UNIX scripting, Java Spring boot and Angular You'll be rewarded and recognized for your performance in an environment that will challen