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Job Details

UnitedHealth Group

Claims Manager - San Juan, PR (16396189)




Full Time


San Juan, Puerto Rico, United States

It's a big step forward when you realize that you've earned the trust to lead a team. Now, let's determine just how big that step can be. Take on this managerial role with UnitedHealth Group and you'll be part of a team that's reshaping how health care works for millions. We're driving ever higher levels of sophistication in how provider networks are composed and perform. Join us and you'll play a key role in directing the management of data and databases of physicians and specialists who are part of our provider networks. You'll join a team of incredibly talented technology and business professionals where you'll find discover the resources, backing and opportunities that you'd expect from a Fortune 5 leader.

Primary Responsibilities:

  • Health Care Provider contracting process operations management
  • Manages multiple teams and processes each with their own set of performance expectations and regulatory requirements
  • Tracks, measures and provides feedback to staff on performance
  • Serves as an operational leader by creating, implementing and approving operational changes through documentation and process flows
  • Participates or leads development of business strategy
  • Ability to interpret, predict and forecast changes in business operational activities and needs
  • Manages teams that generate revenue and savings
  • Reviews the work of others and make course corrections as needed
  • Develops innovative approaches and strategies
  • Anticipates customer needs and proactively develop solutions to meet them
  • Solves complex problems and develops innovative solutions with broad impact on the business
  • Provides explanations and information to others on difficult issues, both within the team and other departments
  • Develops and leads projects that drive process improvements
  • Serves as an operational leader in client implementations
  • Tracks and reports business performance using dashboards and scorecards
  • Candidate must be highly organized with effective and persuasive communication skills
  • Strong analytical, problem solving and decision-making skills required; ability to exercise good judgment
  • Open to change and new information; ability to adapt behavior and work methods to changing organization and integrate best practices
  • Interpersonal skills to influence and spur cultural change, facilitate and enhance performance within a cross-functional environment
  • Ability to gain acceptance for ideas, plans, actions and then implement flawlessly
  • Effective data analysis and interpretation skills


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:

  • Bachelor’s Degree in a relevant discipline (business management, project management, etc.)
  • 2+ years of experience in Claims Proccessing in the healthcare industry
  • 2+ years of experience utilizing operational metrics, data/analytics, goals/objectives, and dashboards to run, interpret, and drive business performance
  • 2+ years of management experience
  • Experience with the Microsoft Office Suite
  • Proficiency in using advanced functions in Microsoft Excel such as filters, pivot tables, formulas, etc.
  • English Proficiency

Preferred Qualifications:

  • Experience in usage of Six Sigma tools
  • Master's Degree
  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

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. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity 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.