31 to 45 of 91
Monitoring and managing staff productivity and quality Personnel management Handling escalated calls to ensure member satisfaction and save time Managing projects as needed Acting as the SME for processes, policies and procedures Identifying potential issues that interfere with workflow Determining and implementing process improvements Identifying trends and ensuring fair workload distribution Own
Posted 1 day ago
Reviews medication orders and evaluates appropriateness and completeness of orders with consideration given to the special needs and behaviors of the specific age group served Verifies all prescriptions not directly received from the prescriber or physician's agent Provide oversight of the safety; appropriateness, and effectiveness of the pharmaceutical care provide to patients (consumers) as it r
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
Develop and deploy predictive data models on large data sets Collaborate and communicate effectively with our broader product teams, while supporting ad hoc analytics where needed Design and run complex data programs Execute creative problem solving and critical thinking on the job Perform quantitative analysis on Actuarial, financial, utilization and costs data You'll be rewarded and recognized
Posted 1 day ago
Lead Strategy development, business planning, and tie into capital planning across OptumHealth Business Units and Markets Provide a level of subject matter expertise in an area of focus / priority Viewed as a critical thought partner / leader by SLT / ELT Leadership Identify, assess, track, and occasionally support the implementation of strategic initiatives (both in and across care delivery marke
Posted 1 day ago
Field inbound calls on a queue from members and providers for the purpose of assessment and triage Manage inpatient mental health cases throughout the entire treatment plan Oversee initial and concurrent admissions for facility based levels of care of psychiatric and chemical dependency patients Make patient assessments and determine appropriate levels of care Determine if additional clinical trea
Posted 1 day ago
Receive, review, and coordinate all information required to initiate a referral for pre authorization for health care services for multiple practices Follow protocols set up by New West Physicians and contracted payors. Utilized New West Physicians Practice Guidelines as required Advise providers concerning the adequacy of the information contained in the referral. Maintain accurate documentation
Posted 1 day ago
Manages clinical and operational staff in the process of medical management of assigned lines of business Guides medical directors and nurses in all aspects of medical care and multi level transitions of care Supports inpatient case review and is accountable for successful bed day management that meets established company goals Analyses utilization data to identify trends and opportunities for pro
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
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
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
Perform research on various computer systems and document customer information regarding current status, payment expectations, notes of conversations and other relevant information Use mail, email and phones to contact customers to discuss, negotiate payment and resolve outstanding medical bill accounts and balances Obtain agreement on potential balance payoff and/or payment terms within stated
Posted 1 day ago
Continuum of care planning that integrates initial assessment of the patient with appropriate post hospital discharge services Must demonstrate excellent communication and collaboration skills Ability to identify gaps and/or barriers in treatment planning Provide patient, family, and/or caregiver education Initiate and ensure completion of all necessary paperwork Provide referrals for community re
Posted 1 day ago
Assumes responsibility for the success of diligence efforts assigned as project lead; contributes to the success of other projects as necessary Provide written communication with client/partners, team members and management the status of assignments on a weekly basis via project documentation (i.e. status update, scope change, etc.) Documents all deliverables including; scope definition, status re
Posted 1 day ago
Develop innovative analytic solutions, create actionable insights and drive better decisions and performance to help the business achieve its business objectives Support operational analytics and process improvement data deep dive, identify and execute on new opportunities for increases in efficiencies and performance Support Clinical Affordability and Utilization Management work Formulate hypothe
Posted 1 day ago
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