Sending correspondence to members Reconciling reports Performing basic data entry functions with proficient PC skills including but not limited to Microsoft products and Quickbooks Analytical and Researching techniques Initiate and assist with developments / changes to increase or change quality and productivity Preparing, processing, and maintaining new member or group e

Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Co

Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Co

Support acquisition initiatives related to payroll and employee integration Serve as point person and resident in training to be expert regarding M&A system updates Execute and validate test scenarios for area of expertise as needed Partner with project team and M&A Payroll team on trouble shooting and resolution of system issues Assist with testing for fixes, enhancement

Monitors daily workload and appropriately distributes work amongst staff Problem solves complex issues related to prior authorizations cases Review and process fax/telephone/computer requests to meet departmental key indicator productivity and accuracy standards; maintain minimum of 95% case data entry accuracy Follow departmental policy regarding accurate documentation o

Addresses the total patient, inclusive of medical, psychosocial, behavioral, cultural, and spiritual needs Involves the individual patient and caregiver, as appropriate, in decision making Facilitates communication and coordination among members of the care team Provides patient care to include patient assessment prior to physician's/nurse practitioner's examination, serv

Intake/screening/referral, assessment/reassessment, development of support plans, on going case management, monitoring of the Member's health and welfare, documentation of contacts and case management activities in the Department prescribed system, resource development, and case closure Respect confidentiality and maintain confidences as described in the UHG Employee Hand

Serves as a resource for UnitedHealthcare's care management and service coordination teams, including reviewing care plans for members who are on medically prescribed diets, receiving gastric tube feeding or experiencing weight loss Identifies members who are at nutritional risk in accordance with medical standards and provides intervention recommendations to our care tea

Identify potential health care business customers Develop business relationships with agents and/or brokers to increase sales Promote sales of health care and ancillary products to Mid Market Employers (2 99 EE) through brokers. This includes educating and keeping brokers up to date on products and pricing, evaluating, and discussing with brokers, developing recommendatio

Engage members telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and me

Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Co

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

Perform HEDIS medical record review for physician offices throughout the state of Nevada Complete inter rater reliability testing and required computer training successfully in order to complete this data collection Conduct additional QI audits through medical record review Educates physicians, RNs and other clinical employees in the latter half of the year You'll be rewa

As part of a multi disciplinary care coordination team Addresses the total patient, inclusive of medical, psychosocial, behavioral, cultural, and spiritual needs Involves the individual patient and caregiver, as appropriate, in decision making Facilitates communication and coordination among members of the care team Provides patient care to include patient assessment prio

Intake/screening/referral, assessment/reassessment, development of support plans, on going case management, monitoring of the Member's health and welfare, documentation of contacts and case management activities in the Department prescribed system, resource development, and case closure Respect confidentiality and maintain confidences as described in the UHG Employee Hand