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

Review requests for proposals (RFPs) and related documents furnished by the procuring agency; analyze to understand and capture specific operational, administrative and proposal requirements Interview subject matter experts (SMEs) in business functions throughout the organization to determine Community & State/UnitedHealthcare business and operational approach to satisfy the requirements Con

Provide skilled nursing care for expectant mothers in the home care environment Travel to provide in home patient care and continuous education to patients and family members Continually assess the mothers’ condition to ensure they are safe in the home environment Modify the plan of care, as appropriate, based upon reassessment, change in prescriber orders, the patient’s need for furth

Develop and implement market business plans to motivate providers to engage in improving Risk Adjustment metrics Provide analytical interpretation of Risk Adjustment reporting including, Executive Summaries, HCC Ratio, Disagree and Resolution rates, and FaxBack reporting to plan and provider groups Subject Matter Expert (SME) for all Risk Adjustment related activities within their assigned marke

Provide a complete continuum of quality care through close communication with members via in person or on phone interaction Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels Assist members with the transition from a care facility back to their home Expect to spend about 80% of your time in the field visiting our m

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 recognized for your performance

Develop and implement market business plans to motivate providers to engage in improving Risk Adjustment metrics Provide analytical interpretation of Risk Adjustment reporting including, Executive Summaries, HCC Ratio, Disagree and Resolution rates, and FaxBack reporting to plan and provider groups Subject Matter Expert (SME) for all Risk Adjustment related activities within their assigned market(

Assist in answering incoming phone calls in a prompt and professional manner Return calls as appropriate Connect and disconnect answering service, and follow up on messages received from answering service Assist in taking phone messages in a concise and complete manner Ensure phone calls will not be left on hold for excessive periods of time Assist “unscheduled” emergencies to the poin

Positions in this function create and deliver high quality system solutions for our applications, products and services across all technology functions They consult with users and technology specialists to define business processes and the information systems for supporting those processes Individuals in these roles may perform analysis and also serve as business liaisons to understand and refine

Processes attestation sheets and progress notes out of the RightFax work queue according to DataRAP® department guidelines Analyzes progress notes and documentation sent by providers for validation following CMS guidelines and ICD 9 / ICD 10 Coding Manual guidelines and enters final results into appropriate tab of the DataRAP® database Performs the minimum number of validations consistent

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 vend

Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs) Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems Own problem through to resolution on be

Energize your career with one of Healthcare’s fastest growing companies. You dream of a great career with a great company where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHea

Support CAHPS and HOS business plans to motivate providers and clinic staff to engage in improving overall Star performance to be 4 STARS or higher Provide member / patients with internal and external resources to improve Social Determinants of Health, and CAHPS and HOS measures Manage outreach campaigns, including inbound calls and calls made via the dialer system Perform required assessments suc

If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Financial discipline and accountability count more today than ever. Which is why your performance and innovation will find a reception here like nowhere else as you help people live healthier lives while doing your life's best work.(sm) You'll enjoy the flexibility to telecomm