46 to 60 of 64
Manage unit cost budgets, target setting, performance reporting and associated financial models Guide development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process controls Ensure that net
Posted 1 day ago
Guide development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management Develop and execute strategies for a function or discipline that span a large business unit or multiple markets / sites Apply network configuration and incentive based payment models as appropriate to improve quality and efficiency Direct others t
Posted 1 day ago
UnitedHealth Group is working to create the Healthcare system of tomorrow and you can help. Already Fortune 7, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good. Through our family of businesses and a lot of inspired individuals, we're building a high p
Posted 1 day ago
Work with UnitedHealthcare members visiting a pharmacy retail location, regarding medical and pharmacy benefits, eligibility & claims issues and assist with plan selection and enrollment. Identify opportunities to connect members to the best resources to meet their healthcare needs and help resolve medical and benefits issues on their behalf Interact with sales, pharmacy, and HouseCalls staff in a
Posted 1 day ago
Receives, reviews and coordinates all information required to initiate a referral for pre authorization for health care services for multiple practices. Follows protocols set up by New West Physicians and contracted payors. Utilized New West Physicians Practice Guidelines as required. Advises providers concerning the adequacy of the information contained in the referral. Makes suggestions within
Posted 1 day ago
Distribute drugs prescribed by physicians and other health practitioners. Provide information to customers about medications and their use. Strong focus on providing a superior level of customer service. Log data into the computer. Ensure compliance with all relevant laws of the applicable State Board of Pharmacy. Administration of immunizations as allowed by state boards of pharmacy. Any other us
Posted 1 day ago
Assist providers with examinations, minor surgical procedures and physicals May be required to perform certain tasks alone as instructed. These procedures may include but are not limited to Medical Duties Injections, sterile field set up, EKG, application of dressings and splints, PFT's, mass removal, flexible sigmoidoscopy, pap smears, pulse oximetry, orthostatic blood pressures, audiograms, spir
Posted 1 day ago
Work with UnitedHealthcare members visiting a pharmacy retail location, regarding medical and pharmacy benefits, eligibility & claims issues and assist with plan selection and enrollment. Identify opportunities to connect members to the best resources to meet their healthcare needs and help resolve medical and benefits issues on their behalf Interact with sales, pharmacy, and HouseCalls staff in a
Posted 1 day ago
Making outbound calls to care providers and minimal inbound calls Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems Contact care providers (hospitals) on behalf of the customer to assist with claims related issues or concerns Research complex issues across multiple databases and work with support resou
Posted 1 day ago
Provide exceptional customer service to all customers while following best practices of call greeting, call handling, call documentation, call resolution and call closure. Provide 1st level technical support by creating and/or resolving ServiceNow Incident and Request cases. Troubleshoot problems with network connectivity, web access, Windows, Outlook access, Exchange, SQL connectivity, and propri
Posted 1 day ago
Performs concurrent review of provider documentation, diagnoses and charge codes for Medicare Advantage members for assigned providers or sites to ensure proper ICD 10, CPT, CPTII, HCPCS and modifiers are applied. Query providers or clinic staff as necessary for clarification of documentation or lack thereof as it pertains to proper application of ICD 10 HCC diagnosis codes. Reviews additional c
Posted 1 day ago
Planning System Center Configuration Manager hierarchy and site systems roles Creating and managing Boundary Groups across one or more Distribution Points Management of site communications. (Bandwidth, Secondary Sites, etc.) Role Based Administration Managing custom roles and security groups General monitoring of site health via SCCM console Planning, configuring and implementing a backup plan
Posted 1 day ago
Making outbound calls to care providers and minimal inbound calls Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems Contact care providers (hospitals) on behalf of the customer to assist with claims related issues or concerns Research complex issues across multiple databases and work with support resour
Posted 1 day ago
Making outbound calls to care providers and minimal inbound calls Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems Contact care providers (hospitals) on behalf of the customer to assist with claims related issues or concerns Research complex issues across multiple databases and work with support resour
Posted 1 day ago
This position's primary responsibility is to provide subject matter expertise on technology posture, capabilities, and roadmap as a trusted advisor to IT, Operational, and Clinical leadership. Working in close collaboration with the CIO/VP Enterprise Architecture, the individual will drive organizational alignment to the multi year technology roadmap, support strategic and tactical initiative plan
Posted 1 day ago
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