Use of own Recovery experience and training to assist families and consumers with defining their Recovery goals, and developing the skills and knowledge needed for the consumer's recovery Experience working with consumers that have co occurring Disorder, i.e., Mental Health and Substance Use Disorder Support the creation and assist with the implementation of a comprehensi

Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medicati

Facilitate, oversee and monitor on going business processes to support HEDIS data reporting Monitor compliance against relevant process requirements (e.g., turnaround time, accuracy) Evaluate processes and outcomes against benchmarks and metrics and identify potential business impacts of current state Ensure all business requirements are met Demonstrate understanding of r

Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, at least restrictive level of care Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact

Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medicati

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 care plans as appropriate based on reassessment, change in prescriber orders, the patient's need for f

Handle escalated calls, resolving more complex customer issues Demonstrate outstanding service to identify the source of the caller's issue and work to resolve the inquires in a timely and professional manner Help guide and educate customers about the fundamentals and benefits of consumer driven health care topics such as selecting the best benefit plan options, maximizin

Addresses the total patient, inclusive of medical, psychosocial, behavioral, cultural, and spiritual needs Involves the individual patient and caregiver, as appropriate, in decision making Facilitates communication and coordination among members of the care team Provides patient care to include patient assessment prior to physician's/nurse practitioner's examination, serv

Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Com

Educate members on health education and condition management (formal and informal), as well as plan specifics and member resources, in collaboration with OptumHealth Referral of employees to available clinical programs including premium designated physicians Create, manage and implement employer specific programs based on employer needs Monitors and analyzes customer spec

Mainly handling inbound calling, NO knocking on doors Answer incoming phone calls from prospective members and identify the type of assistance and information the customer needs with the goal to convert the caller to a qualified lead and ultimately sale Ask appropriate questions and listen actively to identify specific questions or issues while documenting required inform

Receive appeal or grievance documentation and determine relevant details (e.g., what member is requesting) Enter appeals and grievances details within the system and audit against provided documentation. Determine where appeal or grievance should be reviewed / handled or route to other departments as appropriate Contact and work with other internal resources to obtain and

Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, at least restrictive level of care Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact

Provide legal and strategic advice on all aspects of real estate matters to the UnitedHealth Group Real Estate Services team Draft, review, and negotiate various commercial real estate agreements including leases and related documents (e.g., letters of intent, subleases, intercompany leases, estoppels, landlord consents, amendments, assignments, etc.), constructions agree

Manages and evaluates direct reports of UM Prior Authorization Nurses, Inpatient Care Managers, Clinical Coordinators, and other team associates Manages the compliance for UM to meet established performance metrics Oversees inventory and ensures cases completed within regulatory timeframes Manages all aspects of the UM program and service timeframes Actively participates