Provide high level of customer service while communicating with internal departments and external provider office staff as pertains to performance of job duties Review and process prior authorization requests to meet departmental key indicator productivity Verifies patient insurance eligibility & benefits to include applicable co pays, co insurances, deductibles, Out of Pocket Maximum, appropriate

Engagement with internal resources to project manage provider issue resolution (claims, credentialing, provider set up) Provider education and outreach regarding policies, processes and ease of use of our provider self service portal, provider express Responsible for the delivery of external provider training and education programs either in person, virtually or through larger external provider ev

Coordinate the strategic development and distribution of all Medicare member communication materials Direct supervision of designated personnel including hiring/terminating, disciplinary actions, assigning/checking work, performance reviews, compensation recommendations, new hire orientation and training Develop and manage strategic initiatives and tracking for multiple sets of existing client spe

Building the data pipeline using big data technologies More than 70%+ of the time spent on coding and/or hands on technical implementation of scalable quality software solutions Lead the design, coding, and unit tests through consistent development practices with a focus on building CI/CD, automated testing, and monitoring Work with large, complex data sets (structured and semi structured) to buil

Provides general building / facility systems maintenance services for safe and comfortable operations Prioritize service calls and follow up upon completion under direction of the facility supervisor Ensures quality and completion of tasks Performs minor construction projects Performs preventive maintenance on building systems Inspects buildings, grounds, and equipment for unsafe or malfunctioning

Provide exceptional customer service to all patients and members of the clinic staff Under direct supervision of the registered pharmacist, fills prescription orders and makes them available for verification by the Pharmacist. Once verified by the pharmacist, dispenses the prescriptions. Order, receive and store incoming pharmacy supplies. Receive and process wholesaler medication orders. Verify m

Building resilient and self scaling systems Oversees the technologies, tools and techniques used by the team Ensure that development standards, security policies and procedures are adhered to Work with the scrum team to get projects developed and implemented Manage Cloud Infrastructure Setup and maintain monitoring, metrics & reporting systems for fine grained observability and actionable alerting

Participate in telephonic outreach for collaboration with treating providers. This will include discussion of evidence based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expenses Responsible to collaborate with operational and business partners on clinical and quality initiatives at the site and customer level to address cust

Conduct solution focused consultations; helping clients define goals, plan action and gain insight Assess and refer to appropriate programs and services including but not limited to Worklife, behavioral health, substance abuse / chemical dependency and community based resources Assist with referrals for members needing ongoing/additional counseling services Provide limited after care monitoring (f

Manages ongoing contract relationships and service delivery to clients for one or more accounts Acts as outward facing, dedicated resource for assigned accounts, typically with direct client contact (not call center) and mid size accounts Builds relationships with employer / group clients (not individual members) Represents client internally and coordinates with other functions to implement client

include Provides and manages remote patient care Use audio and visual technology to complete patient examinations, evaluations, assessments, diagnoses, and treatment plans Communicates with patients regarding testing results, follow up care, and additional information Prescribes pharmaceuticals, other medications, and treatment regimens as appropriate to assessed medical conditions Refers patient

Completes telephonic outreach to DSNP members utilizing auto dialer and manual dialing Educates member on gaps in care and assists with scheduling provider appointments Assists members with social determinants of health and links to community resources Ensures member has access to PCP Identifies gaps in care and assists in closure of gaps Outreaches members on caseload consistent with program guid

Assist Associate Director with developing and executing comprehensive team strategies and operational plans to meet both short and long term business objectives. Develops, streamlines and improves workflows and oversee procedures relating to policy development involving safety sensitive and federally mandated regulations such as DOT, NRC, DFWP, FAA, Workplace Violence and Fitness for Duty processe

Assist with escalated claims to resolve complex issues for team members and internal customers Support implementation of updates to the current procedures and assist with new system training/mentoring Review guidelines as well as benefit plan documents and certificates to ensure proper benefits have been applied to each claim Analyze and identify trends and provide reports as necessary This is a c

For those who believe in the power of data to help write the next chapter in the history of health care, here's your opportunity. Advancement, an elite group of peers, variety of product lines, and rewards for delivering on our mission ensures you will always be challenged at UnitedHealth Group to do your life's best work.(sm) The Senior Underwriter will analyze health benefit plan characteristics