NHS Human Services, Inc.

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, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The monitor team has 24/7 coverage for the following applications: IBMi Book A systems, Robot scheduler and console, Tidal scheduler, and Sterling Integrator. The monitor team answers messages where the correct response can be determined, and triages errors to the correct team, depending on the contents or ‘location’ of the message.

Primary Responsibilities:

• IBMi Health Monitoring

• Claim adjudication jobs

• Go into msgw for processing bad records

• Monitor team can answer to ‘resubmit’ job

• Cannot answer automatically, as that can lead to a ‘run away’ job

• ASP alerts

• In addition to automated warnings

• Monitor team can monitor for ‘faster than normal’ rise in percentage

• CPU alerts

• In addition to automated warnings

• Monitor team can alert on-call if necessary

• Claims queue monitoring

• Reject percentage

• Estimated Standard Deviation

• 5 seconds or greater count

• Robot Job Monitoring

• Research and react to robot job messages

• Knowledge of Robot job failure point

• Call program

• SXCMFTNDM command

• Missing object

• Mod or Patch issue

• Can the message be answered by a monitor

• What team should be contacted

• Does the job message require a contact with on-call

• Should account management for the client be included

• Will the job have a large downstream impact

• Monitor jobs that are running outside of normal parameters

• Eligibility jobs ‘in suspense’

• Looping commands

• Reset inbound automation

• MAC file processing completion

• Robot job queue health

• Too many jobs in queue

• Reassignment to other priorities/queues if possible

• Notify on-call

• Submit - Hold - Release robot jobs

• Payment balancing

• Ensures payment has balanced on multiple environments

• Submits payment group jobs

• Completes balancing and submits payment jobs on consolidated pharmacy system (RXCNP)

• Answers multiple messages that appear for $0 payment batches

• Alert teams when EDI jobs are in error

• Collaborate with Government Programs team, Eligibility team, Accumulator team, Account Management, to understand robot job failures and messages

• Complete tickets associated with robot job failures

• Notify necessary teams if a client has an emergency issue (24/7)

• Work with Account Management if client needs an immediate answer

• Knowledge of job types and their importance

• Test jobs

• Reactive jobs

• Dependent jobs

• Group jobs

• Blue-chip clients

• Reference file loads

• Alert necessary personnel for Reference File issues

• Medispan

• FDB

• NCPDP

• HMS

• Redbook

• Complete audit process for failed Robot jobs

• Ensure all robot job failures are associated with an open Service Now ticket or as a known issue

• Ensure all tickets are resolved

• 127 job failures per week since January 1st 2019

• Inbound robot job monitoring

• Missed SLA deliveries for CIGNA/HealthSpring files

• In sequence loading of State of Washington 501 eligibility files

• Nevada Medicaid in sequence loading for eligibility, prior authorization, provider files

• Hospiscript in sequence file loads (1 file every 7 minutes)

• MAC file in SLA loading

• CMS response file load submitter IDs

• Reference file loads within SLA

• Tidal job monitoring

• Monitor all servers

• Submit - Hold - Release jobs

• Mark jobs as complete

• Engage Tidal Admins when jobs fail

• Alert business partners of failed jobs

• Assist in determining why job has failed

• Suggest alternative solutions

• Populate and research associated ‘run book’

• Billing and Payment services jobs

• Client invoicing

• Claims payment

• Billing

• Tidal completes a number of automatic monitoring processes

• Ensure the alert outputs are addressed

• Email alerts

• Service Now ticket creation

• Sterling Integrator Monitoring

• Monitor Database usage

• Indexing processes

• Purging processes

• Database connectivity

• Dynatrace alerts

• Orion notifications

• In Error Business Process Usage

• All queues could indicate that there is a problem with file delivery or business processing

• Active queue

• Halted queue

• Waiting queue

• WaitingOnIO queue

• Interrupted_Man queue

• Knowledge is necessary to understand if the queue population is an issue or individual problems

• Stagnant Message alerts

• Files that need to be reflagged to be picked up by routing rules

• Could indicate an issue with connectivity to IBMi system

• Could indicate an issue with outbound connectivity

• IRIS file delivery is run through Sterling Integrator

• Monitor team would discover issues with delivery

• EDI 835 Payment files

• Scriptmed

• EskerFax

• Sterling Integrator file delivery errors (first and second level research)

• Service Now ticket (CASE) created

• Unusual amount of tickets created

• Knowledge of why tickets are being produced

• Ticket generation does not have any automatic alerting

• Multiple possible errors within tickets created

• Pull errors

• Connectivity

• Delete

• Push errors

• Put

• Connectivity

• Mailbox errors

• Internal network delivery errors

• PGP encrypt and decrypt errors

• Archival errors

• False positive errors

• Continuous issue resolution

• Internal build errors

• External connectivity errors

• Extensive business partner collaboration

• Communicate with client contacts

• Provide explanation and possible error points

• Additional contact to bring issue to resolution

• 5 day follow-up process

• Business partner contacts

• Credential errors

• Working Directory errors

• Missing or not delivered files

• Explanation for failure to deliver

• Act as liaison between internal partners

• Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Required Qualification:

• Undergraduate degree or equivalent experience

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.