Positions in this function are responsible for providing expertise or general support to teams in reviewing, researching, investigating, negotiating, and resolving all types of appeals and grievances Communicates with appropriate parties regarding appeals and grievance issues, implications, and decisions Analyzes and identifies trends for all appeals and grievances May re

Implement and maintain data bases necessary to complete standard reportable event reports and analysis within agreed upon deadlines surrounding the HCBS LTSS population Complete ad hoc reports and analysis as requested by State partner or internal LTSS leadership Routinely analyze results of reportable event submissions, substantiations, and CAPs to identify trends such a

Develop, lead, and execute category management plans, competitive events, deal analysis, and complex negotiations for IT Software/Hardware and Services Support the end to end procurement process from sourcing through contracting, including pipeline management, in accordance with category strategy Review, develop, redline, and negotiate complex third party vendor contracts

The Sr. Sourcing & Procurement Consultant, Sourcing & Procurement (IT) will be expected to Develop and support technology strategies for Hardware, Software Licensing and Maintenance Execute on strategies by drafting commercial agreements, benchmarking rates, negotiating contract terms and conditions (leveraging UnitedHealth Group's terms and internal subject matter expert

Work with a wide range of internal clients and internal/external attorneys to address inquiries, assess development projects, and provide guidance on patentability Mentor and advise inventors on patentability and invention disclosures Assist in the management of a growing docket of patent filings Perform analytics on patent portfolio and create reporting Assist in the dev

Sales representative for the UHC Key Accounts responsible for broker and direct sales to customers in the 100 5000 employee range. The principle focus is the sale of new fully insured and self funded business with indirect responsibility for the retention of existing accounts New Business Sales Identifies potential healthcare business customers Accountable for prospect fr

Serve as primary care manager for high medical risks / needs members with comorbid behavioral health needs Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs Develop and implement individualized, person centered care plans inclusiv

Field inbound calls in a queue from members and providers for purpose of assessment and triage Focus on initial inpatient admission for psychiatric and chemical dependency patients Make patient assessments and determining appropriate levels of care Participate in member crisis calls Determine if additional clinical treatment sessions are needed Manage inpatient mental hea

Serve as primary care manager for high medical risks / needs members with comorbid behavioral health needs Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs Develop and implement individualized, person centered care plans inclusiv

Serve as primary care manager for high medical risks / needs members with comorbid behavioral health needs Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs Develop and implement individualized, person centered care plans inclusiv

Serve as primary care manager for high medical risks / needs members with comorbid behavioral health needs Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs Develop and implement individualized, person centered care plans inclusiv

Serve as primary care manager for high medical risks / needs members with comorbid behavioral health needs Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs Develop and implement individualized, person centered care plans inclusiv

Key Agent/Agency Performance Agent Development Mentor, coach and engage key agents/agencies through ongoing business and strategy planning. This includes identifying sales opportunities, product positioning, UHC tools, UHC value proposition, compliance, and market education Onboarding Reach out to new agents identified by the PHD to share UHC learning, growth tools and va

Conduct financial and network pricing modeling, analysis and reporting Perform unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies Lead projects to completion by contributing to database creation, statistical modeling and financial reports Concisely summarize and communicate the results of complex an

Full oversight of the specialty sale at the direction of the AE/SAE to achieve health plan market sales goals and maintain profitability Advocate for specialty voluntary products to support increase in enrollment and size of sale and negotiate based on broker/customer feedback with underwriting; leveraging rate bank, product discount programs and packaged savings to lever