Perform initial review of consumer health records and current health status (e.g., health risk scores) to identify health risk and determine next steps Conduct initial and ongoing assessments utilizing nursing assessment skills in home setting Receive information from consumers about specific symptoms and questions Conduct interviews to understand cause and effect, gather or review health history

Manage the product delivery for the consumer facing, digital experience at Naviguard Day to day collaboration and decision making with cross functional agile teams including architects, developers, scrum master, designers and business or subject matter representatives Responsible for defining the requirements/user stories and acceptance criteria of a product feature Performs testing validation of

Answering incoming calls and greet patients Coordinate patient flow Assist patients with intake or admitting processes Collect co payments, co insurance and deductibles The pace is fast, so your ability to multi task is essential. You should also enjoy working with people and have the communication skills necessary to build strong relationships with our patients. You'll be rewarded and recogni

Design and build technical processes to address Operations business issues Oversee the design and delivery of reports and insights that analyze business functions and KPI's Build, develop and maintain data models, reporting systems, data automation systems, dashboards and performance metrics support that support key business decisions Recruit, train, develop and supervise analyst level employees O

Assist in opening and closing the clinic, locking and unlocking the doors, and maintaining a clean waiting area Welcome all On Site Clinic patients and visitors by greeting them with a friendly demeanor, answering inquiries and directing them through the registration process. Answer multi phone lines, filing, faxing, scanning documentation and completing daily patient callbacks Collect all insuran

Works primarily with the physician community around issues of particular patients, balancing business and clinical concerns Provides limited utilization management for outpatient medical, surgical and pharmacy activity Participates in medical appeals activity. May be asked to review 2nd level overturned cases related to medical necessity/investigational issues in the context of potential medical p

Prepare, process and maintain new member or group enrollments Respond to member eligibility or group questions and verify enrollment status Reconcile eligibility discrepancies, analyze transactional data and submit retroactive eligibility changes Research errors by comparing enrollment error reports against system information along with records from the Center for Medicare and Medicaid Services Yo

Perform and support operating expense forecasting for M&R Sales commissions, M&R Executive functions, and support monthly business reporting for various Government Program entities Compile SG&A estimates and daily close reporting during the Month End Close cycle (WD's 3 through WD 6) Analyze and report on monthly financials, and partner with senior leaders and finance counterparts to collaborative

Greets patients and escorts them to exam room. Performs hand washing, weighs patients, takes vital signs and patient history, and documents chief complaint. May administer limited injections requested by a physician and supervised by a physician, registered nurse, nurse practitioner or physician assistant in accordance to established regulations, in conjunction with attending and passing Injection

Possess strong clinical and operational knowledge having worked in the designated medical specialty of Radiology Design, develop and evaluate clinical programs in collaboration with other internal teams and oversee effective implementation in partnership with business partners The National Medical Director partners closely with ACO / Organized Systems of Care leadership, Clinical Policy and Appeal

Analyzes and investigates root cause of non compliant cases. Create and Maintain SharePoint for focus area Responds to routine or standard governance, compliance and PG inquiries. Support short and long term operational/strategic business activities by developing, enhancing and maintaining operational information and models. Perform quality management of technician work Perform Utilization Licensi

Support NetworX requirements definition and documentation, Configuration, UAT, training and implementation Utilize available tools provided by relevant State or Federal websites to obtain pertinent Fed/State Regulatory Fee Schedules Support planning and implementing NetworX software releases including testing and training Support the development and execution of NetworX test plans and scenarios fo

Serves as an expert resource to POI leaders with implementation of business standards. Ensure deliverables are met within scope and resource constraints Recognize risks proactively and utilize appropriate resources to develop mitigation strategies that minimize customer and operational impact Collaborates with matrix partners and stakeholders across UHG in development of new and expanded intervent

Medical Director careers at UnitedHealthcare are anything but ordinary. We push ourselves and each other to find smarter solutions. The result is a culture of performance that's driving the healthcare industry forward. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Join us. And start doing your life's best work.(sm) The UnitedHealthcare Maternal

Compile and analyze complex data sets Develop data collecting functions for new and existing financial databases Present analysis and interpretation for operational and business review and planning Support short and long term operational / strategic business activities through analysis Develop recommended business solutions through research and analysis of data and business process and implement w