Accountants and Auditors

We are a proud work-from-office company. If you're ready to work on-site in a dynamic, global company, we’d love to hear from you.

About Us

Vensure Employer Solutions is the largest privately held organization in the HR technology and service sector, providing a comprehensive portfolio of solutions, including HR/HCM technology, managed services, and global business process outsourcing (BPO). The company and its service providers collectively serve over 95,000 businesses and process over $135B in annual payroll. As a "One Employer Solution” headquartered in Chandler, Arizona, Vensure helps thousands of businesses streamline and grow their operations with custom strategies that benefit both employers and employees. Find out more by visiting www.vensure.com .

Position Summary

The Sr Payroll Tax Specialist will provide support between new division partners and internal tax departments. It will consist of gathering and analyzing information from the new divisions staff and tax/payroll system to facilitate integrating with us. Ensure Payroll Tax department is processing liability payments, tax returns, notices, etc., timely and accurately. Complete projects as assigned, including registration for bulk filing, ACH Credit, etc.

Essential Duties and Responsibilities

Participate in and lead projects to continuously improve the efficiency of the tax department processes and procedures to enhance speed, quality, efficiency, and output.

Track and provide overall status updates, maintaining project plans and monitoring overall project health.

Ensuring projects meet deadlines

Securing growth opportunities and initiating new projects

Optimizing and improving processes and the overall approach where necessary

Other duties as assigned.

Knowledge, Skills, and Abilities

A thorough knowledge and understanding of payroll tax and the regulatory environment, which includes federal, multi-state, and local tax regulations

The ability to read, understand, and analyze highly complex regulatory payroll tax information.

Interpret and analyze complex data, make determinations free from immediate direction, and ensure that payroll taxes are appropriately processed.

The ability to manage multiple tasks, meet deadlines and adapt to fast-paced environment.

Intermediate to advanced Excel skills.

The ability to work both independently and collaboratively and possess strong customer service skills.

Education & Experience

Minimum of three years multi-state, multi-jurisdiction and high-volume Payroll Tax experience

Minimum of one years of recent Senior, Lead or Supervisor experience required.

PEO or related industry experience preferred.

Hands-on tax return processing experience is required.

Strong knowledge of multi-state payroll, federal, state and local wage laws required.

MasterTax and Prism/HRP experience preferred.

Required Licenses And/Or Certifications

Certified Payroll Professional (CPP) certification or Fundamentals of Payroll Certification (FPC) preferred

We are a proud work-from-office company. If you're ready to work on-site in a dynamic, global company, we’d love to hear from you.

About Us

Vensure Employer Solutions is the largest privately held organization in the HR technology and service sector, providing a comprehensive portfolio of solutions, including HR/HCM technology, managed services, and global business process outsourcing (BPO). The company and its service providers collectively serve over 95,000 businesses and process over $135B in annual payroll. As a "One Employer Solution” headquartered in Chandler, Arizona, Vensure helps thousands of businesses streamline and grow their operations with custom strategies that benefit both employers and employees. Find out more by visiting www.vensure.com .

Position Summary

The Senior Account Manager is responsible for the oversight and ongoing management of their assigned Account Manager(s) and clients. The SR. Account Manager works with sales and the support teams to implement new or renewing accounts, ensuring that a high service level is met. The SR. Account Manager will also work with high-level, key employees to maintain the ongoing client relationships. Being extremely knowledgeable about group benefits, having excellent problem resolution and negotiation skills is key. The SR. Account Manager must also be personable, maintain a high-level of professionalism and be able to travel for client meetings.

Essential Duties and Responsibilities

Daily management of assigned Account Manager(s)

Mentoring and training of Account Managers

Coordinate and conduct the implementation for new and renewing clients.

Coordinate strategy meetings and document collection with Business Consultant.

Market, analyze, and negotiate benefits and rates for all coverages.
Request renewal from carrier.

Conduct pre-renewal and renewal meetings (in person or via Zoom).
Negotiate renewals with carriers. Quote open market when necessary.
Deliver final renewal to client and finalize benefit selections.

Obtain applications and monitor benefit administration portals.

Ensure everything is submitted in a timely manner (minimum 15 days prior to the effective date)

Perform first bill audits and host a meeting with client to discuss how the OE went.

Ensure a high level of customer retention and satisfaction by building relationships with key contacts.

Ensure high levels of service are delivered to ALL clients:

High-level of professionalism and customer service to employees.

Provide 24-hour response times to requests, if resolution is not able to be obtained within 24 hours make sure to keep lines of communication open with client by providing status updates.

Education is key for all employees and key contact.

Ensure all clients are compliant with their benefits, contributions, etc.
Select filings of compliance documents

COBRA

Knowledge, Skills, and Abilities

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Personal qualities of integrity and credibility.

Must be able to work individually and as part of a team.

Must be able to use the utmost discretion in all presentations/correspondence and communication for staff, clients and all leadership.

Intermediate (or higher) knowledge of Microsoft Office and Adobe.
Work requires professional, written, and verbal communication and interpersonal skills.

Strong organizational skills with the ability to multi-task and prioritize to meet stated deadlines.

Knowledge of employee benefits, compliance, and payroll.
Must be able to read, analyze, and interpret Client, technical procedures, insurance regulations, and governmental regulations.

Ability to respond effectively to the most sensitive inquiries and complaints.

Ability to define problems, collect data, establish facts, and draw valid conclusions.

Education & Experience

2- 5 years or equivalent combination of experience, skills, education (including other relevant non-traditional degree programs, certifications, or job training programs) preferred.

Bachelor's degree preferred

Health and Life Insurance License mandatory

We are a proud work-from-office company. If you're ready to work on-site in a dynamic, global company, we’d love to hear from you.

About Us
Vensure Employer Solutions is the largest privately held organization in the HR technology and service sector, providing a comprehensive portfolio of solutions, including HR/HCM technology, managed services, and global business process outsourcing (BPO). The company and its service providers collectively serve over 95,000 businesses and process over $135B in annual payroll. As a "One Employer Solution” headquartered in Chandler, Arizona, Vensure helps thousands of businesses streamline and grow their operations with custom strategies that benefit both employers and employees. Find out more by visiting www.vensure.com .

Position Summary

The Account Manager is responsible for the oversight and ongoing management of their assigned clients. The Account Manager works with sales and the support teams to implement new or renewing accounts, ensuring that a high service level is met. The Account Manager will also work with high-level, key employees to maintain the ongoing client relationships. Being extremely knowledgeable about group benefits, having excellent problem resolution and negotiation skills is key. The Account Manager must also be personable, maintain a high-level of professionalism and be able to travel for client meetings.

Essential Duties and Responsibilities

Coordinate and conduct the implementation for new and renewing clients.

Coordinate strategy meetings and document collection with Business Consultant and Benefit Sales Consultant.

Market, analyze, and negotiate benefits and rates for all coverages.
Request renewal from carrier.

Conduct pre-renewal and renewal meetings (in person or via technology platform).

Negotiate renewals with carriers. Quote open market when necessary.
Deliver final renewal to client and finalize benefit selections.

Obtain applications and monitor benefit administration portals.

Ensure everything is submitted in a timely manner (at minimum 15 days prior to the effective date)

Perform first bill audits and host a meeting with client to recap open enrollment success and takeaways.

Ensure a high level of customer retention and satisfaction by building relationships with key contacts.

Ensure high levels of service are delivered to ALL clients:

High-level of professionalism and customer service to employees.

Provide 24-hour response times to requests, if resolution is not able to be obtained within 24 hours make sure to keep lines of communication open with client by providing status updates.

Education is key for all employees and key contact.

Ensure all clients are compliant with their benefits, contributions, etc.
Select filings of compliance documents

COBRA

Assist with ACA compliance

Medicare filings

Knowledge, Skills, and Abilities

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Personal qualities of integrity and credibility.

Must be able to work individually and as part of a team.

Must be able to use the utmost discretion in all presentations/correspondence and communication for staff, clients and all leadership.

Intermediate (or higher) knowledge of Microsoft Office and Adobe.

Work requires professional, written, and verbal communication and interpersonal skills.

Strong organizational skills with the ability to multi-task and prioritize to meet stated deadlines.

Knowledge of employee benefits, compliance, and payroll.

Must be able to read, analyze, and interpret Client, technical procedures, insurance regulations, and governmental regulations.

Ability to respond effectively to the most sensitive inquiries and complaints.

Ability to define problems, collect data, establish facts, and draw valid conclusions

Education & Experience

2- 5 years or equivalent combination of experience, skills, education (including other relevant non-traditional degree programs, certifications, or job training programs) preferred

Bachelor's degree preferred.

Health and Life Insurance License mandatory.

HigherEd - Salesforce Partner Alliances Director
19388
Chandler, AZ
8/20/2024 2:33:00 PM
CRM
FTE - IntraEdge

Job Description
IntraEdge, Inc. is a leading provider of technology solutions and services, specializing in Salesforce higher education implementations, consulting, and support. With a focus on delivering exceptional client experiences, IntraEdge helps organizations achieve their business objectives through innovative technology solutions.

Location: United States/Canada

The Salesforce Partner Alliances Director will be responsible for developing and managing a robust channel partner ecosystem within the Higher Education industry. This role involves recruiting, enabling, and supporting channel partners to drive sales and market penetration of Salesforce solutions within colleges and universities.
Job Requirements

Responsibilities:
Develop and execute a comprehensive channel strategy aligned with the company's overall business objectives for the Higher Education market.
Work with sales and delivery teams to develop an overall go to market strategy and blueprint.
Recruit, onboard, and manage a network of channel partners, independent software vendors (ISVs), systems integrators (SIs), and other strategic partners.
Establish and maintain strong relationships with channel partners, providing them with the necessary training, resources, success metrics, and support to achieve sales goals.
Develop and implement channel partner incentive programs and sales enablement tools.
Collaborate with sales and marketing teams to develop joint go-to-market strategies and campaigns.
Track and analyze channel partner performance metrics to identify opportunities for improvement and growth.
Stay up to date on industry trends, competitive landscape, and Salesforce product offerings.

Qualifications:
Bachelor's degree in business, marketing, or related field.
Minimum of 5 years of experience in channel management or business development within the technology industry.
Proven track record of building and managing successful channel partnerships.
In-depth knowledge of the Salesforce platform and ecosystem.
Strong understanding of the Higher Education market and its specific needs.
Excellent communication, interpersonal, and presentation skills.
Ability to build and maintain strong relationships with internal and external stakeholders.
Strong analytical and problem-solving skills.
Ability to work independently and as part of a team.

Additional consideration for:
Experience working with Salesforce for Education Cloud.
Knowledge of CRM and other higher education software solutions.
Experience with channel partner relationship management (PRM) software.

If you're a passionate and results-oriented partner and alliances lead who thrives on growing your network and building relationships, we want to hear from you!

HigherEd - Salesforce Marketing Cloud Solution Architect
19395
Chandler, AZ
8/20/2024 4:14:00 PM
CRM
FTE - IntraEdge

Job Description
IntraEdge is seeking a seasoned Salesforce Marketing Cloud Architect with a deep understanding of higher education to join our team. This role is pivotal in designing, implementing, and optimizing comprehensive marketing automation solutions for our clients in the higher education sector. The ideal candidate will possess a strong blend of technical expertise and strategic thinking to drive successful marketing campaigns and improve student recruitment, engagement, and retention.
Location: United States/Canada

Are you a visionary Salesforce Marketing Cloud Solution Architect with a passion for transforming higher education with Marketing Cloud?

IntraEdge is seeking a highly skilled and experienced Salesforce Marketing Cloud Solution Architect to lead the design, development, and implementation of innovative marketing solutions for the higher education industry. The ideal candidate will possess a deep understanding of higher education marketing challenges and opportunities, as well as a proven track record of success in leveraging Salesforce Marketing Cloud to drive student recruitment, engagement, and retention.

Job Requirements
Responsibilities:

Lead the architecture and design of complex Salesforce Marketing Cloud solutions aligned with higher education business goals.
Develop and implement comprehensive data strategies, including data integration, cleansing, and segmentation.
Architect and execute multi-channel marketing campaigns across email, SMS, mobile, and social media channels.
Leverage AI and machine learning capabilities within Marketing Cloud to optimize campaign performance.
Integrate Salesforce Marketing Cloud with other Salesforce clouds (Sales Cloud, Service Cloud, Education Cloud) utilizing the Marketing Cloud Connector and external systems.
Provide functional leadership and mentorship to the marketing cloud team.
Stay up to date with the latest Salesforce Marketing Cloud features and leading practices.
Collaborate with clients to understand their marketing objectives and translate them into functional requirements.
Work with the leadership, sales, and alliances team to develop a go-to-market strategy with prescribed service offerings for higher education clients.
Support the development of RFP responses, proposals, and SOWs.
Support orals presentations in response to proposals for clients.
Work with Salesforce AEs and SEs to develop go-to-market messaging and assets to support the sales pipeline.
Qualifications:

Bachelor's degree in Marketing, Information Technology, or related field.
5+ years of experience in Salesforce Marketing Cloud implementation and architecture.
Experience with Salesforce Journey Builder, Automation Studio, and Interaction Studio.
Salesforce Marketing Cloud Consultant Certification required.
Proven experience in higher education marketing and student recruitment.
Strong understanding of data management, analytics, and reporting.
Expertise in email marketing, SMS, mobile marketing, and social media marketing.
Experience with data integration and ETL processes.
Strong analytical and problem-solving skills.
Strong project management and organizational skills.
Excellent communication and interpersonal skills.
Additional Considerations for:

Knowledge of industry standards and regulations (e.g., FERPA, GDPR, CAN-SPAM, etc).
Experience with data analytics and reporting tools (e.g., Tableau, Google Analytics).
Understanding of marketing automation platforms and technologies.
Experience with Salesforce Data Cloud and/or other CDP solutions.
If you're a passionate and results-oriented solution architect who thrives on creative problem-solving, we want to hear from you!

HigherEd - Salesforce Marketing Cloud Business Analyst
19396
Chandler, AZ
8/20/2024 4:25:00 PM
CRM
FTE - IntraEdge

Job Description
IntraEdge, Inc. is a leading provider of technology solutions and services, specializing in Salesforce higher education implementations, consulting, and support. With a focus on delivering exceptional client experiences, IntraEdge helps organizations achieve their business objectives through innovative technology solutions.

Location: United States / Canada

We are seeking a highly skilled and analytical Salesforce Marketing Cloud Business Analyst to join our team. This role is instrumental in bridging the gap between business needs and technical solutions within the higher education sector. The ideal candidate possesses a deep understanding of Salesforce Marketing Cloud, higher education marketing, and a proven ability to translate complex business requirements into actionable technical specifications.
Job Requirements
Responsibilities:
Collaborate with higher education stakeholders to understand their marketing goals, challenges, and processes.
Conduct thorough requirements gathering and analysis to identify opportunities for Salesforce Marketing Cloud to enhance marketing effectiveness.
Develop detailed functional and technical specifications for marketing automation workflows, email campaigns, and other marketing initiatives.
Create process flow diagrams, user stories, and other documentation to clearly communicate requirements.
Analyze marketing data to identify trends, patterns, and insights that inform strategic decision-making.
Develop key performance indicators (KPIs) and reporting dashboards to measure marketing campaign performance.
Leverage data to optimize marketing campaigns and improve ROI.
Collaborate with project managers and development teams to ensure successful implementation of Salesforce Marketing Cloud projects.
Provide ongoing support and troubleshooting for Salesforce Marketing Cloud users.
Identify opportunities to streamline marketing processes and improve efficiency.
Implement leading practices for marketing automation and data management.

Qualifications:
Bachelor's degree in Marketing, Business Administration, Information Technology, or related field.
Proven Business Analyst experience.
In-depth knowledge of Salesforce Marketing Cloud, including email studio, journey builder, automation studio, and data extensions.
Strong analytical and problem-solving skills.
Excellent written, communication, and interpersonal skills.
Ability to translate complex technical concepts into understandable business terms.
Experience with data analysis and reporting tools.

Additional consideration for:
Experience with Salesforce and Automated Marketing Tools.
Understanding of higher education admissions, student lifecycle management, and advancement and alumni processes.
Experience in lead generation and sales enablement.
Salesforce Marketing Cloud and Business Analyst certifications.
Experience with other Salesforce products (Sales Cloud, Service Cloud, Data Cloud, Education Cloud, etc).
Knowledge of SQL and data modeling.

If you're a passionate and results-oriented marketing analyst who thrives on growing your network and building relationships, we want to hear from you!

HigherEd - Salesforce Business Analyst
19389
Chandler, AZ
8/20/2024 2:47:00 PM
CRM
FTE - IntraEdge

Job Description
IntraEdge, Inc. is a leading provider of technology solutions and services, specializing in Salesforce higher education implementations, consulting, and support. With a focus on delivering exceptional client experiences, IntraEdge helps organizations achieve their business objectives through innovative technology solutions.
Location: United States/Canada

IntraEdge is seeking a talented Salesforce Business Analyst with a passion for higher education to join our team. In this role, you will play a critical role in bridging the gap between business needs and technical solutions, ensuring successful Salesforce implementations for our higher education clients.
As a Salesforce Business Analyst, you will collaborate closely with clients, project teams, and stakeholders to gather requirements, analyze processes, and document detailed functional specifications. You will be responsible for translating business needs into actionable requirements that drive the development of effective Salesforce solutions.
Job Requirements
Responsibilities:
Conduct in-depth business process analysis to identify opportunities for improvement and automation.
Elicit, document, and validate business requirements through interviews, workshops, and documentation.
Develop detailed functional specifications, user stories, and process flows.
Create data mapping and conversion plans.
Collaborate with technical teams to ensure that business requirements are accurately translated into technical designs.
Support the development and testing of Salesforce solutions.
Facilitate user acceptance testing (UAT) and gather feedback.
Provide ongoing support to clients after project implementation.
Stay up to date on Salesforce platform features and industry leading practices.
Qualifications:
Bachelor's degree in Business Administration, Information Systems, or a related field.
2+ years of experience as a Business Analyst, with a focus on Salesforce implementations.
Experience configuring and implementing business functionality in Salesforce Sales, Service, or Education Clouds.
Proven experience in higher education and the student lifecycle.
Strong analytical and problem-solving skills.
Excellent communication and interpersonal skills.
Ability to translate complex business requirements into clear and concise documentation.
Experience with data analysis and modeling.
Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint).
Preferred Qualifications:
Salesforce certifications (e.g., Salesforce Certified Business Analyst, Salesforce Administrator)
Experience with Agile development methodologies.
Knowledge of SQL and data visualization tools.
If you're a passionate and results-oriented business analyst who thrives on creative problem-solving, we want to hear from you!

HigherEd - Salesforce Advancement Business Analyst
19393
Chandler, AZ
8/20/2024 3:02:00 PM
CRM
FTE - IntraEdge

Job Description
IntraEdge, Inc. is a leading provider of technology solutions and services, specializing in Salesforce Higher Education implementations, consulting, and support. With a focus on delivering exceptional client experiences, IntraEdge helps organizations achieve their business objectives through innovative technology solutions.
Location: United States/Canada

IntraEdge is seeking a talented Salesforce Advancement Business Analyst with a passion for Higher Education to join its team. In this role, you will play a critical role in bridging the gap between business needs and technical solutions, ensuring successful Salesforce implementations for our Higher Education advancement clients.
As a Salesforce Advancement Business Analyst, you will collaborate closely with clients, project teams, and stakeholders to gather requirements, analyze processes, and document detailed functional specifications. You will be responsible for translating business needs into actionable requirements that drive the development of effective Salesforce solutions.
Job Requirements
Responsibilities:
Conduct in-depth business process analysis to identify opportunities for improvement and automation.
Elicit, document, and validate business requirements through interviews, workshops, and documentation.
Develop detailed functional specifications, user stories, and process flows.
Create data mapping and conversion plans.
Collaborate with technical teams to ensure that business requirements are accurately translated into technical designs.
Support the development and testing of Salesforce solutions.
Facilitate user acceptance testing (UAT) and gather feedback.
Provide ongoing support to clients after project implementation.
Stay up to date on Salesforce platform features and industry leading practices.
Qualifications:
Bachelor's degree in Business Administration, Information Systems, or a related field.
3+ years of experience as a Business Analyst, with a focus on Salesforce implementations.
Proven experience in Higher Education advancement, including fundraising, alumni relations, and donor management.
Strong analytical and problem-solving skills.
Excellent communication and interpersonal skills.
Ability to translate complex business requirements into clear and concise documentation.
Experience with data analysis and modeling.
Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint).
Additional experience for consideration:
Salesforce certifications (e.g., Salesforce Certified Business Analyst, Salesforce Administrator)
Experience with Agile development methodologies.
Knowledge of SQL and data visualization tools.
If you're a passionate and results-oriented business analyst who thrives on creative problem-solving, we want to hear from you!

HigherEd - Salesforce Account Executive
19390
Chandler, AZ
8/20/2024 2:52:00 PM
CRM
FTE - IntraEdge

Job Description
IntraEdge, Inc. is a leading provider of technology solutions and services, specializing in Salesforce Higher Education implementations, consulting, and support. With a focus on delivering exceptional client experiences, IntraEdge helps organizations achieve their business objectives through innovative technology solutions.

Location: United States/Canada

IntraEdge is seeking a dynamic Salesforce Account Executive to join its Higher Education team. As a key member of our sales organization, you will play a pivotal role in driving revenue growth by identifying, qualifying, and closing sales opportunities within the Higher Education market.
Job Requirements
Responsibilities:
Identify, qualify, and develop new sales opportunities within the Higher Education market and maintain an accurate pipeline with supporting details in the CRM .
Build and maintain strong relationships with key decision-makers at target Higher Education institutions and the Salesforce alliance network.
Understand the unique needs and challenges of Higher Education institutions and effectively communicate how Salesforce solutions can address them.
Develop and execute strategic account plans to drive revenue growth and customer satisfaction.
Collaborate with the sales and delivery teams to ensure successful project implementation and customer retention including continuous feedback loops for process improvement.
Achieve and exceed sales quotas and key performance indicators.
Participate in industry conferences and events to generate leads and build brand awareness.
Effectively navigate Higher Education procurement processes and facilitate internal reviews.
Leading RFP responses and developing SOWs for client engagements.
Qualifications:
Bachelor's degree in business, marketing, or a related field.
5+ years of successful sales experience in the Higher Education industry.
Proven track record of meeting and exceeding sales quotas.
Strong understanding of the Higher Education landscape and the challenges faced by institutions.
In-depth knowledge of Salesforce and its applications in Higher Education.
Excellent communication, presentation, and negotiation skills.
Ability to build and maintain strong customer relationships.
Self-motivated and results-oriented with a strong work ethic.
Ability to successfully operate in high growth, fast-paced organization.
Proactive sales style and approach.
Consistent over-achievement of quota and revenue goals.
Experience calling on C-suite and key executives within a client's organization.
Strong operational and analytical abilities.
Excellent written and verbal communication skills.

Additional consideration for:
Salesforce implementation sales experience is highly preferred.
Experience with Salesforce CRM.
Knowledge of Higher Education admissions, student lifecycle management, and fundraising processes.

If you're a passionate and results-oriented account executive who thrives on growing your network and building relationships, we want to hear from you!

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start **Caring. Connecting. Growing together.**

This position will be responsible for the gathering and auditing of medical records from contacted medical providers. Analyze, track, and report results. Recommend, develop, educate and implement quality improvement plans with providers and follow up as necessary.

If you reside in Phoenix, AZ, you will enjoy the flexibility of a hybrid-remote role as you take on some tough challenges.

**Primary Responsibilities:**

+ Review and audit Medicaid (AHCCCS) Electronic Visit Verification (EVV) providers and medical records regarding AHCCCS AMPM requirements around EVV

+ Review, audit and evaluate documentation of medical records

+ Review/interpret medical records/data to determine whether there is documentation reflected accurately in medical record

+ Follow relevant regulatory guidelines, policies and procedures in reviewing clinical documentation

+ Prioritize providers for medical chart review according to collaboration with other Health Plans

+ Identify incomplete/inconsistent information in medical records and label missing measures/metrics/concerns

+ Review relevant tool specifications to guide chart review

+ Review/interpret/summarize medical records/data to address any quality of care questions

+ Verify necessary documentation is included in medical records

+ Maintain HIPAA requirements for sharing minimum necessary information

+ Based on review of clinical data/documentation, identify potential quality of care issues (e.g., variations from standard practice potentially resulting in adverse outcomes) and potential fraud/waste/abuse.

+ Refer issues identified to relevant parties (e.g., review committee, Case Management, Medical Directors) for further review/action

+ Discuss with provider offices to address and request corrective action plans

+ Educate provider representatives/office staff to address/improve auditing processes

+ Educate providers on proper medical record documentation for regulatory compliance

+ Educate providers offices on specifications/measures

+ Explain/convey technical specifications regarding action plans/follow up

+ Explain how provider scores are calculated/determined

+ Demonstrate knowledge of public healthcare insurance industry products (Medicaid

+ Demonstrate knowledge of Medicaid benefit products including applicable state regulations

+ Demonstrate knowledge of applicable area of specialization (e.g., community-based services)

+ Demonstrate knowledge of computer functionality, navigation, and software applications (e.g., Windows, Microsoft Office applications, phone applications, fax server)

+ Demonstrate knowledge of specific software applications associated with the job function (e.g., navigation of relevant computer applications or systems, intranet databases, records management or claims database

+ Prepare for and participate in meetings with State agencies, providers, and stakeholders as well as internal meetings

+ Assist with other quality management audits, corrective action plans as needed

+ This position will have on site provider location visits throughout Arizona

+ This position is a work from home position with 50% in state travel

**What are the reasons to consider working for UnitedHealth Group? Put it all together – competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:**

+ Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays

+ Medical Plan options along with participation in a Health Spending Account or a Health Saving account

+ Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage

+ 401(k) Savings Plan, Employee Stock Purchase Plan

+ Education Reimbursement

+ Employee Discounts

+ Employee Assistance Program

+ Employee Referral Bonus Program

+ Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)

+ More information can be downloaded at: http://uhg.hr/uhgbenefits

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)

+ Active and unrestricted LPN license in the state of Arizona

+ 3+ years of experience in the Medicaid health field including provider interactions

+ 2+ years of experience reviewing medical record charts/documentation and writing regulatory reports

+ Intermediate level of proficiency with software applications that include, but are not limited to, Microsoft Word, Excel and Teams

+ Reliable transportation for field visits

+ Ability to travel 50% for the position throughout Arizona when business requires

+ Reside in Arizona

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

_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission._

_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, #Red