Conduct in home assessments on health plan members, including past medical history, review of symptoms, physical examination, medication review and depression screening Responsible for checking vitals, conducting a physical exam that includes monofilament test, urine dipstick and foot exam (as appropriate) Identify diagnoses to be used in care management and active medical management in the furthe

Perform clinical documentation review of inpatient and outpatient care delivered to adults and children with Medicaid, Medicare health care benefits through Arizona United Health Care Community Plans for peer review and internal investigations of Quality of Care concerns Create professionally written case investigation summaries for Peer Review, present case summaries at the Provider Advisory Comm

Lead Optum Behavioral Technology data engineering delivery and create data foundation to enable Behavioral strategic pillars Participate in sessions to design API solutions centered around Kafka / Cassandra technologies and public cloud Engage directly with Engineering resources in a peer coding relationship to build out solutions utilizing new technologies Participate in the Engineering Center

Assist physicians and nursing personnel with injections, EKGs, phlebotomy and other patient care procedures Maintain established quality control standards Record and process patient care documentation quickly and accurately Coordinate patient care as directed by physicians, company standards and policies Organize, stock and clean exam and treatment rooms and sterilize instruments Maintains quality

In collaboration with the external communications team, support and drive proactive and reactive communications for UnitedHealthcare Community & State community plans Act as point of contact for community plan team on communications requests and inquiries. Support and implement communications initiatives with goals, objectives, strategies, and priorities for community plans. Develop communication

Researching errors by comparing enrollment error reports against system information along with CMS (Center for Medicare and Medicaid Services) records Sending correspondence to members or CMS (Center for Medicare and Medicaid Services) to gather information or provide updates for corrections Reconciling reports Performing basic clerical functions with proficient PC skills Analytical and Researchin

Investigating, reviewing, and providing clinical and/or coding expertise/judgement in the application of medical and reimbursement policies within the claim adjudication process through medical records review Serve as a Subject Matter Expert (SME), performing medical record reviews to include quality audits, as well as validation of accuracy and completeness of all coding elements, and medical nec

Identify and document credentialing, compliance and contract requirements as the enroll in LHI's network to include creation and maintenance of practitioner record within database Initiate, retrieve, verify, and follow up on all credentialing applications and content needed for LHI's practitioner network. Ensure applications are complete, data integrity is intact within database to meet requiremen

Manage multiple IT projects with various internal and external (vendor) IT teams in a changing environment Manage project resources across multiple IT teams in a highly matrix environment and across mix methodology projects (agile and waterfall/iterative) May perform business analysis tasks as needed Primary point of contact for technology deliverables across all impacted systems including vendors

Perform clinical documentation review of inpatient and outpatient care delivered to adults and children with Medicaid, Medicare health care benefits through Arizona United Health Care Community Plans for peer review and internal investigations of Quality of Care concerns Create professionally written case investigation summaries for Peer Review, present case summaries at the Provider Advisory Comm

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 pati

Data Entry of all required billing information that appears on requisitions and laboratory reports Entry of demographic and billing information in multiple hospital and laboratory interfaces Understanding of Laboratory Pathology reports Understanding of requests for services on a laboratory requisition Ability to meet quality and production standards Ability to work in a fast paced environment Det

Participate in team projects / initiatives as directed by management Perform security restricted processes Collaborate with peers to resolve problems Develop and manage relationships with all levels of support personnel Develop proficiency with the software and hardware used and supported by the organization Support desktop issues including installing and upgrading software, installing or replacin

Provide monthly financial reporting of key business initiatives Provide ongoing financial analysis of development and operational results against the budget Work side by side with the Business Team and/or Finance personnel within OptumHealth and/or across other aspects of UnitedHealth Group, to fully understand the business and support the financial goals and objectives Develop and implement contr

Answer and resolve inbound technical contacts at a large corporate Service Desk efficiently and professionally, in a high volume call center environment Diagnose hardware, software, printing, and network connectivity issues including LAN, WAN, and VPN access in a Windows 10 environment, offering advanced level 1 solutions over the phone, via chat or email Use remote control/assistance tools to ass