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UnitedHealth Group logo
Company Name:
UnitedHealth Group
Approximate Salary:
Not Specified
Brooklyn, New York
United States
Position type:
Experience level:
Education level:

Regulatory Affairs Analyst, Fair Hearing Representative New York, NY

Bring us your experience, your head for strategy, your strength with relationships and your eye for opportunity. In return we offer an unmatched place to grow and develop your career among a richly diverse group of businesses driven by thepower and stability of a leading health care organization. Come help us heal and strengthen the health care system as you do your life's best work.(sm)

Primary Responsibilities:

  • Conducting research and preparing for NYS Fair Hearings, including but not limited to: conducting a timeline review of events, collecting evidence, preparing an evidenciary packet, and drafting a written submission for the Fair Hearing

  • Narrate a story both verbally and in a clear and concise written format

  • Personally attend hearings and present the Plan's position to an Administrative Law Judge (ALJ) at the hearing offices in downtown Brooklyn, attend hearings via telephone for the rest of NYS, and support the team in complying with Fair Hearing decision

  • Analyzes and investigate

  • Provides explanations and interpretations within area of expertise

  • Perform data analyses, manipulation and comparisons

  • Provide product and / or regulatory training to clients and business partners

  • Triage reimbursement and product issues from clients and business partners

Required Qualifications:

  • Bachelor's degree or equivalent work experience
  • 2+ years of experience in a health care regulatory environment (managed care, and / or compliance expertise preferred)
  • 1+ years of experience with understanding of personal care services, skilled nursing facilities, claims payment and/or reimbursement, and pharmacy claims related issues
  • Strong problem solving and analytical skills
  • Exceptional interpersonal and negotiation skills
  • Strong verbal and written communication skills

Preferred Qualifications:

  • Exposure to Fair Hearings
  • System knowledge with any of the following: Facets, eMedNy, Care1/IQ, ECAA

Careers at UnitedHealthcare Community & State. Challenge brings out the best in us. It also attracts the best. That's why you'll find some of the most amazingly talented people in health care here. We serve the health care needs of low income adults and children with debilitating illnesses such as cardiovascular disease, diabetes, HIV / AIDS and high-risk pregnancy. Our holistic, outcomes-based approach considers social, behavioral, economic, physical and environmental factors. Join us. Work with proactive health care, community and government partners to heal health care and create positive change for those who need it most. This is the place to do your life's best work.(sm)

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.

Job Keywords: Managed Care, Compliance, Claims, reimbursement, regulatory, Facets, eMedNy, Care1/IQ, ECAA, New York City, NY, New York,

Associated topics: antibody, biopharma, cytometry, disease, healthcare, immunohematology, medical, metabolism, protein, virus

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