The Telephonic Case Manager RN in Medical Oncology provides remote nursing support by coordinating patient care, educating members, and ensuring adherence to treatment plans. This role involves assessing patient health, identifying barriers, and connecting patients with necessary resources to improve health outcomes. Working primarily via telephone, the position requires strong clinical expertise, communication skills, and proficiency in healthcare technology systems.
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
We're making a solid connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that's driving the health care industry forward. As a Telephone Case Manager RN with UnitedHealth Group, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today!
The Telephonic Case Manager RN Medical/Oncology will identify, coordinate, and provide appropriate levels of care. The Telephonic Case Manager RN Medical/Oncology is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting.
This is a full-time, Monday - Friday, 8am-5pm position in your time zone.
You'll enjoy the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
Make outbound calls and receive inbound calls to assess members current health status
Identify gaps or barriers in treatment plans
Provide patient education to assist with self-management
Make referrals to outside sources
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
This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. Solid computer and software navigation skills are critical. You should also be solidly patient-focused and adaptable to changes.
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
Current, unrestricted RN license in state of residence
Active Compact RN License or ability to obtain upon hire
3+ years of experience in a hospital, acute care or direct care setting
Proven ability to type and have the ability to navigate a Windows based environment
Have access to high-speed internet (DSL or Cable)
Dedicated work area established that is separated from other living areas and provides information privacy
Preferred Qualifications
BSN
Certified Case Manager (CCM)
1+ years of experience within Medical/Oncology
Case management experience
Experience or exposure to discharge planning
Experience in a telephonic role
Background in managed care
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Keywords:
telephonic case management, oncology nurse, patient education, care coordination, medical management, healthcare advocacy, remote nursing, chronic disease management, UnitedHealth Group, RN license
$45k-53k yearly est. 7d ago
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Medicaid Community Health Outreach Coordinator - Remote in Mesa County, CO andsurrounding areas
Unitedhealth Group 4.6
Remote or Grand Junction, CO job
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
Organize, collect, review and report physical and behavioral health and social information through member home visits and phone outreach, while demonstrating multicultural sensitivity and effective communication skills with Medicaid members. This position follows established safety protocols in the community setting, as well as established preventive and disease management programs for health promotion and education. Deliver culturally appropriate information regarding the availability of health and community resources that will reduce barriers to care.
If you reside locally to Mesa, CO, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
Serves as a consultant to care coordination teams
Respect confidentiality and maintain confidences as described in the UHG Employee Handbook and acknowledged through signature by all employees. The ability to maintain confidentiality is a critical and essential component of this position
Participate in Interdisciplinary care team meetings as indicated
Serve as community liaison and maintain relationships with key individuals in the community and serve as an advocate by coordinating linkages or referrals to improve health, social, and environmental conditions for members
Coordinate and perform duties of communicating the mission and role of the organization to community associations, senior groups, ethnic clubs and groups, and churches
Serve as the direct personal contact in the community to members who are unable to be reached through phone calls
Conduct member assessments
Assess the changing needs and condition of the client and communicate this information to all involved Care Coordinators, community partners, physician and other appropriate individuals, according to department policies and procedures
Document assessments, client/family response to care coordination interventions at the time of the encounter. Meet departmental standards and deadlines for timely completion of all required documentation and meet current agency productivity standards
Educate and assist identified members about behaviors that can enhance their health, successfully navigating the health system
Facilitate access to preventive and disease management health services
Manage difficult to reach and non-compliant members
Develop a plan of management associated with health care goals for each member addressing the diverse needs in a culturally appropriate way
Develop and maintain a report system for outcomes
Communicate member issues requiring interventions to appropriate departments and providers
Maintains confidentiality and uses only the minimum amount of protected health information (PHI) necessary to accomplish job related responsibilities. Maintain confidentiality of patient information
Participate in staff meetings, case conferences and in-services. Maintain familiarity with all policies and procedures that impact decisions and care
This position requires travel Requires independent, reliable, flexible, and on-demand, transportation at the incumbent's expense for travel between various locations and timely arrival and departure from various locations. If the employee chooses to satisfy this requirement by driving a vehicle, the employee must meet the requirements for Colorado licensure and company requirements for liability insurance coverage
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
Must possess one of the following:
Bachelor's degree in a human services field such as Social Work, Social Sciences, Counseling, Child, Family and Community Services, Early Childhood Development, Guidance and counseling, Home Economics - Child Family Services, Human Development Counseling, Human Service Administration, Human Services, Pastoral Care, Pastoral Counseling, Psychology, Public administration, Rehabilitation, Social Services or Sociology
Fellow designation from the Academy of Healthcare Management (AHM)
4+ years of case management experience
2+ years of progressive related experience working with diverse populations, community or faith-based organizations
Knowledge of health education, motivational strategies, and an empathetic manner working with the underserved
Reliable transportation and the ability to travel up to 25% within assigned territory to meet with members and providers
Reside within Mesa or surrounding area
Preferred Qualifications:
Health care setting experience
Knowledge of healthcare business
Knowledge of local area
Bilingual in English and Spanish
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $23.41 to $41.83 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
$23.4-41.8 hourly 3d ago
Underwriting Consultant National Accounts West Region
Unitedhealth Group 4.6
Remote or Cypress, CA job
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together
The Underwriting Consultant will analyze health benefit plan characteristics and assess risks as to frequency and potential severity of losses of clients. This individual will analyze health benefit plan characteristics and assess risks as to frequency and potential severity of losses of clients. Will utilize established underwriting criteria and policies to provide proper rating methodologies. Will build and maintain models to assist in the economic analysis of market alternatives. The Underwriting Consultant will evaluate and recommend alternative pricing options and plan design changes based on economic analysis and trends. This individual will also prepare financial modeling for reserve calculation, budget calculation, and other ongoing reviews that directly aligns with client strategies. They will validate renewals and request for proposals for accuracy including utilization & experience reporting.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
Primary focus will be on a National Accounts book of business
Intricate focus on product integration to maximize company financials
Work closely with underwriting and National Accounts account management to derive competitive financial responses
Meets quarterly reporting requirements
Anticipates customer needs and proactively develops solutions to meet them
Serves as a key resource on complex and/or critical issues
Solves complex problems, develops innovative solutions, and performs complex analyses
Reviews work performed by others and provides recommendations for improvement
Forecasts and plans resource requirements
Authorizes deviations from standards
May lead functional or segment teams or projects
Provides explanations and information to others on the most complex issues
Motivates and inspires other team members
Develops innovative approaches
Sought out as an expert and serves as a leader/ mentor
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
3+ years of experience in the healthcare industry underwriting/managing financials for a defined book of business for any variety of products: PPO, HMO, Stop Loss, Pharmacy, Dental, Vision, Ancillary, Self-Funded, ASO/Fully-Insured for group or individual clients
1+ years of experience with Risk Management
Intermediate level of proficiency with MS Office suite (including Word, Excel and PowerPoint)
Proven excellent communication skills, both orally and in writing
Preferred Qualification:
Ability to understand and calculate revenue, expense, risk and profit
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
$71.2k-127.2k yearly 3d ago
Actuarial Consultant ALDP - Remote
Unitedhealth Group 4.6
Remote or Minnetonka, MN job
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
At United HealthCare, your performance, your ideas and your innovative thinking will help us improve the lives of millions. As the Actuarial Consultant, you'll play a pivotal role in shaping pricing strategies and ensuring compliance for one of UnitedHealthcare's most innovative and high-profile products. The role requires a self-starter who can effectively manage timelines to meet filing deadlines and possesses the ability to communicate effectively with Departments of Insurance (DOIs) to address their objections.
The challenges here are significant. You'll be responsible for the ownership of the Stop Loss rate filing preparation and submission process essential to the success of our Level Funded business and for contributing to the development of the pricing behind those filings. You'll also be counted on to perform analyses to support business leaders and inform decisions for this flagship offering.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
Own the preparation and submission of Level Funded Stop Loss rate filings while adhering to a defined filing schedule
Independently manage and respond to filing objections from DOIs
Assist in development of Level Funded Stop Loss pricing to support traditional and non-traditional products
Contribute to ad hoc analyses assigned to the broader team
Collaborate and communicate effectively with broader teams and DOIs
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
Bachelor's degree or equivalent experience
Fellow of Society of Actuaries (FSA), Associate of Society of Actuaries (ASA), or near ASA designation
3+ years of Actuarial/Analytical/Data Science/Healthcare experience
Hands-on experience in building actuarial models
Basic or higher level of proficiency in SAS (Statistical Analysis System), SQL (Structure Query Language) or other programming system
Preferred Qualifications:
Experience working with health care claims experience (i.e., understanding of costs, expected claims, benefit pricing...)
Expertise in modeling for stop loss, excess of loss and reinsurance
Advanced or higher proficiency in SAS (Statistical Analysis System) or SQL (Structure Query Language) or other programming system
Excellent communication skills
Excellent organizational and documentation skills
Proven problem-solving skills (identification of issue, causes, solution, implementation plan)
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
$56k-72k yearly est. 5d ago
Director of Automation & Operational Excellence (Remote)
Unitedhealth Group 4.6
Remote or Wausau, WI job
A leading healthcare company is seeking a Director - Automations & Efficiencies to lead innovative projects aimed at enhancing operational effectiveness. This role involves overseeing automation initiatives in a healthcare environment, managing strategic partnerships, and improving processes through advanced technologies. The ideal candidate has significant experience in healthcare payer operations, RPA technologies, and cross-functional leadership. This position offers flexibility to work remotely from anywhere within the U.S.
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$97k-116k yearly est. 4d ago
Provider Relations Advocate - Remote in KS
Unitedhealth Group 4.6
Remote or Overland Park, KS job
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
There are changes happening in health care that go beyond the basics we hear in the news. People like you and organizations like UnitedHealth Group are driving ever higher levels of sophistication in how provider networks are formed and operate. The goal is to improve quality of service while exploring new ways to manage costs. Here's where you come in. You'll use your solid customer service orientation and knowledge of insurance claims to serve as an advocate for providers in our networks. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 5 leader.
If you are in the State of Kansas or within 50 miles of the border, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
Assist in end-to-end provider claims processing and resolution
Assist in efforts to enhance ease of use of physician portal and future services enhancements
Assist in identifying gaps in network composition and services to support network contracting and development teams
Use pertinent data and facts to identify and solve a range of problems within area of expertise
Investigate non-standard requests and problems, with some assistance from others
Work exclusively within a specific knowledge area
Prioritize and organize own work to meet deadlines
Provide explanations and information to others on topics within area of expertise.
Use pertinent data and facts to identify and solve a range of problems within area of expertise
Investigate non-standard requests and problems, with some assistance from others
Work exclusively within a specific knowledge area
Provide explanations and information to others on topics within area of expertise.
Analyzes and investigates claim issues
Responsible for training providers on a variety of topics in both small and large settings
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
2+ years of experience working with Medical Providers
1+ years of experience with Medicaid Regulations
1+ years of experience in providing training or education
1+ years of medical insurance claims/billing experience
Willingness and ability to speak and meet with Providers directly on a variety of topics
Demonstrated excellent written and oral communication skills
Ability to work independently and remain on task with little to no day to day supervision
Demonstrated good organization, planning skills
Ability to prioritize and meet deadlines from multi staff members through the department
Intermediate level of proficiency in claims processing and issue resolution
Exceptional presentation, written and verbal communication skills
Intermediate level of proficiency with MS Word, Excel, PowerPoint and Access
Driver's license and access to reliable transportation
Ability to travel on up to 25% of the time within the State of KS
Preferred Qualifications:
2+ years of provider relations and / or provider network experience
2+ years of experience of Medicaid experience
1+ years of KS Medicaid and Kansas Billing requirements
Previous experience with CSP Facets
Intermediate level knowledge MS Word, Excel, PowerPoint
Intermediate level of claims processing and issue resolution
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
$28k-38k yearly est. 1d ago
Mental Health Clinical Wellbeing Specialist - Remote in CA
Unitedhealth Group 4.6
Remote or Cypress, CA job
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
The Clinical Wellbeing Specialist role is a part of a clinical team focused on behavioral health and emotional wellbeing navigation and support. The team is responsible for care and case management, which includes authorizations and coordination and assurance of appropriate levels of care to members, along with in the moment solution focused consultations and crisis support.
The Clinical Wellbeing Specialist provides one-to-one engagement support with members using clinical expertise to conduct a thorough telephonic assessment of risk to self or others, clinical screening for substance abuse and medical co-morbidities for members. Solution Focused Consultation, Motivational Interviewing, and Short-Term problem resolution are the clinical modalities used to develop an individualized action plan, guiding members to appropriate benefits and resources provided by employer, community and other cross-carrier vendors. The role will provide case management services through review and evaluation of inpatient and outpatient behavioral health treatments for medical necessity, emergency status, and quality of care. The team is empowered to achieve the best possible outcome for the consumer by understanding where the consumer is at with their needs and ensuring the member receives the right care at the right time. The role includes telephonic, digital chat, and/or digital messaging for member interaction. Clinical specialists also coordinate and facilitate the response to high-risk situations through consultation with licensed staff. Work volume comes from both an inbound and outbound queue, both on demand and self-managed.
Clinical Wellbeing Specialists are trained on the foundations of coaching and expected to fulfill their job duties by applying this skillset as a means of experience design. Clinical Wellbeing Specialists are expected to support goal articulation and activate the appropriate benefit or resource available to each unique member. This includes various clinical resources both within the team, as well as through broad partnerships in the organization.
If you are located in California, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
Engage individually with members to clinically and holistically assess the reason for call and presenting needs including issues impacting the individual's personal wellbeing, emotional and physical health, and personal safety
Genuine passion for improving a member's behavioral health experience, supporting adults, youth, and families
"Provides services for adults, youth and families via inbound and outbound phone queues, inbound chats, and additional communications"
Anticipates member needs and proactively identifies solutions
Conduct thorough assessment of risk of harm to self, or others; assist with safety planning and coordinating services with emergency personnel and hospital staff through consultation with other licensed staff in order to access appropriate level of care and ongoing support
Coordinate follow-up care and services to individuals and organizations, as appropriate
Develop next steps and identify meaningful goals and resources utilizing Solution Focused Consultation model
Provide appropriate type of service based on member's presentation, clinical history and needs and accurately differentiate between EWS and BH services
Formulate short term problem resolution plan of action and provide Full Benefit Exploration reviewing the appropriate tools and resources to support the plan, offer and refer clients to additional benefits, and authorize additional services including behavioral health, and/or contracted
EWS and behavioral health network providers
Formulate accurate description of member's clinical presentation in their individual clinical records and maintaining appropriate records, case notes, forms and reports as well as database entries
Provide training in coaching skills foundations and successfully employs techniques in engagements with a focus on member goal articulation and achievement
Fosters a service-oriented environment and participates in human centered experience development
Identifies solutions to non-standard requests and problems
Solves moderately complex problems and/or conducts moderately complex analyses
Works with minimal guidance; seeks guidance on only the most complex tasks
Translates concepts in practice
Provides explanations and information to others on difficult issues
Coaches, provides feedback and guides others, acting as a resource for others with less experience
Participate in staff meetings, case consultations, and training opportunities
Consult as required with other licensed staff and supervisors
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
Licensed Mental Health Clinician with a Master's degree in psychology, social work, counseling or marriage, or family counseling, or an RN with 3+ years of experience in behavioral health
Active, unrestricted independent clinical license in the state of California
Ability to work any of our 8.5-hour shift schedules during our normal business hours of Monday-Friday 6:45am - 7:15pm CST. It may be necessary, given the business need, to work occasional overtime
Designated workspace and access to secure high-speed internet via cable/DSL in home
Permanent residence in the state of California
Preferred Qualifications:
2+ years of child and family experience
Experience supporting members in an inbound call center
Proven solid written, verbal and interpersonal skills. Able to use various computer applications and move through computer screens while talking with members
Ability to build rapport, assess and address risk, and develop goals with members in a telephonic and/or online
Ability to work with a culturally and geographically diverse population
Ability to address a variety of problems and issues as presented by members
Ability to work flexibly and creatively with other professional team members
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
$28.3-50.5 hourly 1d ago
Healthcare Economics Consultant - Remote
Unitedhealth Group 4.6
Remote or Minnetonka, MN job
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
Support internal clinical, financial and quality data analysis to support value-based care agreements with various provider types at a national and local level
Create and support standard financial, utilization and quality reporting in accordance with contracting guidelines
Support ad-hoc analysis through gathering claims, financial, or membership data and summarizing key findings clearly with limited guidance
Support internal data analysis and other deliverables through data troubleshooting and data validation with guidance
Understand conceptual strategies and be able to present key deliverables, answer questions, participate in discussions, and make recommendations via meetings and emails
Lead projects to completion by contributing to the analysis and creation of financial reporting or the automation of reporting
Proactively manage routine processes and anticipating customer needs through independent prioritization
Serve as a resource to executive leadership in support of value based contracting strategy
Solve complex and ambiguous problems with broad impact on the business through critical thinking and resourcefulness
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
3+ years of experience in an analytics capacity with evidence of proactive critical thinking and creative problem solving
Experience in the healthcare insurance industry with exposure to medical claims data
Intermediate or higher level of proficiency in MS Excel and Pivot Tables
Beginner or higher level of proficiency with coding in Snowflake, Toad, Snowsight, SQL, or SAS
Demonstrated highly effective verbal and written communication skills for a variety of audiences
Demonstrated ability to effectively manage multiple priorities
Preferred Qualification:
Demonstrated familiarity with SMART or other claims platform
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
$72.8k-130k yearly 3d ago
Software Engineer - Remote
Unitedhealth Group 4.6
Remote or Irvine, CA job
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
The Enterprise Information Security (EIS) team is responsible for cybersecurity across our organization. We support our business and members by reducing risk, rapidly responding to threats, focusing on business resiliency and securing new acquisitions.
Hiring a Quality Engineer who has a passion for learning, is a solid problem solver, and a critical thinker with broad technical experience. We need someone who has a background and experience with both legacy and new product development utilizing DevOps delivery. This role is for an individual contributor on an Agile team requiring hands-on technical skill and problem-solving for a large, complex Microsoft .NET full stack application development project. This is a Software Development Engineer in Test (SDET) role and requires skills with solid Microsoft .NET, C# Software Engineering to design and build advanced automated test suites using object-oriented methodologies. The role will cover development and testing (manual and automated) activity across all technology functions that ensure we deliver code with high quality for our application, product and services and to understand customer needs.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
The role includes, but is not limited to: Analyze User Stories / Bugs, Design / Design Review, Document, Code / Code Review, Test (Unit, Assembly, System & Regression), Deployment, & Post-deployment Support
Delivery requires automated test (manual testing as needed) mindfulness
Engineering focus on enriching the Customer Experience through high quality functional delivery, efficiency, testability, reliability, scalability, availability, and security of applications.
Foster high performance, collaborative technical work
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
4+ years of experience with testing and test automation development
2+ years of experience with C# and .NET Software Development Life Cycle (SDLC)
2+ years of experience with RESTful Web API Development
2+ years of experience using SQL, Microsoft SQL Server, & SQL profiling skills / performance tuning SQL
Expertise in Agile and DevOps methodologies skills
Proven excellent analytical, problem solving and troubleshooting abilities
Demonstrated skills in active listening with the ability to express oneself clearly and effectively
Demonstrated skills and experience in collaborating, influencing, problem solving and negotiating
Preferred Qualifications:
Git Source Code Management, Test Automation, Azure DevOps Application Lifecycle Management (ALM)
Proven solid organizational skills and focus on accuracy and attention to detail
Identity and Access Management experience
Directory Services Development, Authentication and Provisioning experience
Requirements and technical specification documentation experience
Proficiency in MS Office (Word, Excel, Outlook, PowerPoint, Access, MS Visio)
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
$72.8k-130k yearly 2d ago
Nursing Facility Care Manager - Western, VA Markets
Unitedhealth Group 4.6
Remote or Waynesboro, VA job
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together
The Nursing Facility Care Manager is responsible for facilitating, promoting, and advocating for the enrollees' ongoing self-sufficiency and independence. This position is responsible for assessment and planning for an identified group of patients in Nursing Facilities. Additionally, the care coordinator is responsible for assessing the availability of natural supports such as the enrollee's representative or family members to ensure the ongoing mental and physical health of those natural supports.
The Nursing Facility Care Manager collaborates with the Interdisciplinary Team to coordinate the delivery of comprehensive, efficient, cost-effective patient care. The Nursing Facility Care Manager will be traveling into nursing facilities, Adult Day Health, and Adult Living Facilities (ALF) to conduct in-depth assessments and develop the plan of care.
The Nursing Facility Care Manager actively assists enrollees with care transitions in collaboration with the Interdisciplinary Team and the acute or skilled facility staff, and the enrollees and / or the enrollees' representatives. The Nursing Facility Care Manager act as liaison between the Health Plan, the Commonwealth, enrollees, and their families.
The Nursing Facility Care Manager follows established professional standards of care, Commonwealth guidelines and policy and procedures.
This is a field-based position visiting Nursing Facilities based in Western VA Markets.
For consideration, you must reside within a commutable distance of Washington County, Grayson County and Smyth County VA Markets Alleghany or Rockbridge Counties in VA.
If you reside within a commutable distance of Washington, Grayson and Smyth County, VA, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
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, medication management and member safety in alignment with evidence-based guidelines
Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan
Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health
Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission
Advocate for members and families as needed to ensure the member's needs and choices are fully represented and supported by the health care team
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
Current and unrestricted Licensed Practical Nurse in the state of Virginia OR Social Work or Human Services (or related field) with a 4-year degree
3+ years of care coordination or behavioral health experience and/or work in a healthcare environment
1+ years of experience with MS Office, including Word, Excel, and Outlook
Experience working with members who have medical needs, the elderly, individuals with physical disabilities and / or those who may have communication barriers
Driver's license and reliable transportation and the ability to travel within assigned territory to meet with members and providers
Preferred Qualifications:
CCM certification
Experience working with Medicaid / Medicare population
Experience working in team-based care
Long term care / geriatric experience
Background in Managed Care
Physical Requirements:
Ability to transition from office to field locations multiple times per day
Ability to navigate multiple locations/terrains to visit employees, members and/or providers
Ability to transport equipment to and from field locations needed for visits (ex. laptop, stethoscope, etc.)
Ability to remain stationary for long periods of time to complete computer or tablet work duties
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $23.89 to $42.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
$23.9-42.7 hourly 1d ago
Community Health Worker - Remote in Wisconsin
Unitedhealth Group 4.6
Remote or Milwaukee, WI job
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts on the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
The Community Health Worker is responsible for assessment, planning and implementing care strategies that are individualized by members and directed toward the most appropriate, least restrictive level of care. They also Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services, and manage the care plan throughout the continuum of care as a single point of contact for the member. As a Community Health Worker (CHW), you will act in a liaison role with Medicaid members to ensure appropriate care is accessed as well as to provide home and social assessments and member education. The coordinator also addresses social determinant of health such as transportation, housing, and food access. In this role, you will assess and coordinate care on behalf of SSI (aged, blind, or disabled) patients. Your experience in a health care environment will be essential in relaying the pertinent information about the members' needs and advocating for the best possible care available. At times, your patience may be challenged. But in the end, your confidence, decisiveness, and perseverance will help you positively impact our members' lives and ensure more positive outcomes for all.
Schedule: Schedule: Monday through Friday 8:00am to 5:00pm CST.
If you are located in Wisconsin, you will enjoy the flexibility to telecommute* as you take on some tough challenges.
Primary Responsibilities:
Engages members primarily over the phone to discuss their health
Create a positive experience and relationship with the members
Proactively engage the members to manage their own health and healthcare
Support the members to improve their well-being by staying out of the hospital, and attend regular visits to their primary physician, via education, clinical resources, and/or membership follow-up
Support the member to ensure pick-up of their prescriptions by providing education, quality compliance, and membership follow-up
Provide member education on community resources and benefits
Listen actively, communicate with empathy and gather information in a respectful manner
Conduct outreach to encourage participation in health-related programs, services, and/or providers
Use methods that promote learning and positive behavior change
Use a variety of interactive teaching and coaching methods for different learning styles
Prepare and distribute education materials and present at community events
Performs all other related duties as assigned
What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:
Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
Medical Plan options along with participation in a Health Spending Account or a Health Saving account
Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
401(k) Savings Plan, Employee Stock Purchase Plan
Education Reimbursement
Employee Discounts
Employee Assistance Program
Employee Referral Bonus Program
Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
More information can be downloaded at: uhgbenefits
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
High School Diploma/GED (or higher)
1+ years of clinical or case management experience
Intermediate level of proficiency with computers and Microsoft Office (Word, Excel, and Outlook)
Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information and live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Ability to work a shift between the hours of 8:00 am - 5:00 pm CST
Must reside in the state of Wisconsin
Preferred Qualifications:
Community Health Worker (CHW) Accreditation
1+ years of experience with knowledge of the resources available, culture, and values in the community
Experience with electronic charting
Knowledge of Medicaid/Medicare population
Knowledge and/or experience with behavioral health or substance use disorders
Works with others as part of a team
Soft Skills:
Strong communication and customer service skills both in person and via phone
Ability to work independently and maintain good judgment and accountability
Demonstrated ability to work well with others
Strong organizational and time management skills
Ability to multi-task and prioritize tasks to meet all deadlines
Ability to work well under pressure in a fast-paced environment
Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.38 to $36.44 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
#RPO #GREEN
$20.4-36.4 hourly 1d ago
Medical Director - Post-Acute Care Management - Care Transitions - Remote anywhere in US
Unitedhealth Group 4.6
Remote or Phoenix, AZ job
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.**
**Why Care Transitions?**
At Care Transitions, our mission is to work with extraordinarily talented people who are committed to making a positive and powerful impact on society by transforming health care. Care Transitions is the result of almost two decades of dedicated visionary leaders and innovative organizations challenging the status quo for care transition solutions. We do health care differently and we are changing health care one patient at a time. Moreover, have a genuine passion and energy to grow within an aggressive and fun environment, using the latest technologies in alignment with the company's technical vision and strategy.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. We are currently looking for Medical Directors that can work daytime in any of the continental time zones in the US.
**Primary Responsibilities:**
+ Provide daily utilization oversight and external communication with network physicians and hospitals
+ Daily UM reviews - authorizations and denial reviews
+ Conduct peer to peer conversations for the clinical case reviews, as needed
+ Conduct provider telephonic review and discussion and share tools, information, and guidelines as they relate to cost-effective healthcare delivery and quality of care
+ Communicate effectively with network and non-network providers to ensure the successful administering of Care Transitions' services
+ Respond to clinical inquiries and serve as a non-promotional medical contact point for various healthcare providers
+ Represent Care Transitions on appropriate external levels identifying, engaging and establishing/maintaining relationships with other thought leaders
+ Collaborate with Client Services Team to ensure a coordinated approach to delivery system providers
+ Contribute to the development of action plans and programs to implement strategic initiatives and tactics to address areas of concern and monitor progress toward goals
+ Interact, communicate, and collaborate with network and community physicians, hospital leaders and other vendors regarding care and services for enrollees
+ Provide leadership and guidance to maximize cost management through close coordination with all network and provider contracting
+ Regularly meet with Care Transitions' leadership to review care coordination issues, develop collaborative intervention plans, and share ideas about network management issues
+ Provide input on local needs for Analytics Team and Client Services Team to better enhance Care Transitions' products and services
+ Ensure appropriate management/resolution of local queries regarding patient case management either by responding directly or routing these inquiries to the appropriate SME
+ Participate on the Medical Advisory Board
+ Providing intermittent, scheduled weekend and evening coverage
+ Perform other duties and responsibilities as required, assigned, or requested
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ Board certification as an MD, DO, MBBS with a current unrestricted license to practice and willing to maintain necessary credentials to retain the position
+ Current, unrestricted medical license and the ability to obtain licensure in multiple states
+ 3+ years of post-residency patient care, preferably in inpatient or post-acute setting
**Preferred Qualifications:**
+ Licensure in multiple states
+ Willing to obtain additional state licenses, with Optum's support
+ Understanding of population-based medicine, preferably with knowledge of CMS criteria for post-acute care
+ Demonstrated ability to work within a team environment while completing multiple tasks simultaneously
+ Demonstrated ability to complete assignments with reasonable oversight, direction, and supervision
+ Demonstrated ability to positively interact with other clinicians, management, and all levels of medical and non-medical professionals
+ Demonstrated competence in use of electronic health records as well as associated technology and applications
+ Proven excellent organizational, analytical, verbal and written communication skills
+ Proven solid interpersonal skills with ability to communicate and build positive relationships with colleagues
+ Proven highest level of ethics and integrity
+ Proven highly motivated, flexible and adaptable to working in a fast-paced, dynamic environment
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Compensation for this specialty generally ranges from $238,000 - $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.
**Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
$238k-357.5k yearly 5d ago
Sales Development Program - Columbus, OH
Unitedhealth Group 4.6
Dublin, OH job
*$2,000 sign on bonus for external candidates plus an additional $1,000 if candidates have their licensure at time of offer. Guaranteed base pay + monthly sales incentive earning potential. Training fully onsite with a hybrid schedule after the completion of training!*
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
We are growing our team in Columbus, Ohio and have multiple Early Careers full-time sales opportunities available - come join our team as a Sales Agent in the Sales Development Program. In this inbound call role, you will receive a competitive base salary and bonuses based on your sales performance. You will consult customers on their insurance needs and match the correct coverages, products and benefits. Our training classes not only prepare you for your role, but we will pay for and provide support for you to obtain the required state insurance licenses. No license is required prior to starting in the role. During training, all new hires will be required to successfully complete the UHC Portfolio Agent New Hire training classes and demonstrate proficiency of the material.
Work Schedule:
Operating hours: Monday - Friday 7:00AM - 9:00PM; your shift will be provided during training with rotational weekend work
Full time position with flexibility desired based on the seasonality of our business
Work Location:
Fast forward your success by participating in our onsite training program in a standard day shift for 6 - 10 weeks
Site location: 5900 Parkwood Place, Dublin, OH 43016
Training fully onsite with a hybrid schedule after the completion of training
Program features:
Participate in a Sales Development Program that will accelerate your career with a company that will help you learn new skills and foster your continued growth
Collaborate with experienced professionals, mentors, and sales leaders
Build relationships within a close-knit community of peers involved in the development program to expand your network
Development program is curriculum based and structured
Program commitment is 18 months
So, what's in it for you?
Compensation & Benefits:
As a licensed agent, your total compensation is determined by your ability to work hard, sell, and deliver a great customer experience
Compensation = Base pay + monthly sales incentive
Average first year annual earnings $60K through a combination of base plus sales commissions
Top performers can earn $80K+
Sign-on bonus of up to $3,000 for external candidates (2k sign on bonus + an additional 1k if you have resident license at the time of offer)
18 days accrued Paid Time Off during first year of employment plus 8 Paid Holidays
Medical Plan options along with participation in a Health Spending Account or a Health Saving account
Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
401(k) Savings Plan, Employee Stock Purchase Plan
Education Reimbursement
Employee Discounts
Employee Assistance Program
Employee Referral Bonus Program
Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
Fun and competitive work environment focused both on teamwork and individual success!
Primary Responsibilities:
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 information in computer systems
Using knowledge of the product portfolio to accurately assess the distinct needs of different prospects, explain the differences between various products, and assist the prospect member in selecting a product that best meets their unique needs
May make outbound calls to members to follow up on questions or to current members to review current or new products and services
Assist the prospect in completion of the enrollment application over the phone with complete, accurate and required information, consistent with product requirements and enrollment guidelines
Meet the goals established for the position in the areas of performance, attendance, and consumer experience
Meet and maintain requirements for agent licensure, appointments, and annual product certification
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
*This is a full-time position with a start date of Monday, June 8, 2026*
*UnitedHealth Group is not able to offer relocation assistance for this position*
*UnitedHealth Group is not able to offer visa sponsorship now or in the future for this position*
Required Qualifications:
Currently in final year of obtaining a Bachelor's degree (or obtained degree no longer than 24 months prior to position start date, from an accredited college/university). Bachelor's Degree must be obtained prior to start of employment
Must be eligible to work in the U.S. without company sponsorship, now or in the future, for employment-based work authorization (F-1 students with practical training and candidates requiring H-1Bs, TNs, etc. will not be considered)
Preferred Qualifications:
Work or volunteer experience in sales, customer service, health care, or health insurance
Experience with Microsoft Office products (Word, Excel, PowerPoint, Outlook)
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16.00 to $24.04 per hour based on full-time employment. This role is also eligible to receive bonuses based on sales performance. We comply with all minimum wage laws as applicable
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
$16-24 hourly 5d ago
Primary Care Advanced Practice Clinician (NP/PA) - EMR Support, Corvallis - Remote within Oregon
Unitedhealth Group Inc. 4.6
Remote or Corvallis, OR job
Explore opportunities at The Corvallis Clinic, part of the Optum family of businesses. For more than 75 years, our multi-specialty group has been committed to delivering exceptional care to our patients and fulfilling careers to our team members. As a leading clinic in Oregon's mid-Willamette Valley, we serve more than a quarter-million people with offices in Corvallis, Albany and Philomath. Join a team that empowers you from the start and values work-life balance, teamwork and trust. We offer comprehensive benefits and competitive pay. Elevate your career with us and discover the meaning behind Caring. Connecting. Growing together.
If you are located within the state of Oregon, you will have the flexibility to work remotely* as you take on some tough challenges.
Position Highlights:
Full Time 40 weekly hours, M-F, 8am-5 pm
95% work from home, after initial onsite training (3-6 months)
All equipment provided
75% inbox management and 25% telemedicine patient care
Live locally within commuting distance to Mid-Willamette Valley
Assessing Red Flag calls escalated from nurse triage and determine appropriate level of care
Tech savvy, Athena EMR
Tele-med acute care phone and video visits
Opportunity for growth
What makes an Optum organization different?
As the largest employer of Advanced Practice Clinicians, we have a best-in-class employee experience and enable you to practice at the top of your license
We believe that better care for clinicians equates to better care for patients
We are influencing change collectively on a national scale while still maintaining the culture and community of our local care organizations
We grow talent from within. No matter where you want to go- geographically or professionally- you can do it here
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
Master's degree from a four-year college and/or a professional certification beyond a four-year college
AANC or AANP certified family nurse practitioner or NCCPA certified physician associate
Active Unrestricted Oregon State Nurse Practitioner or Physician Assistant License or ability to obtain prior to employment
Current Oregon DEA certificate or the ability to obtain prior to employment
Access to reliable high-speed internet
Able to work well with others in a team environment
Live locally within commuting distance to Corvallis\Albany, OR
Preferred Qualifications:
2+ years of clinical practice experience
Urgent Care or ER experience
Solid understanding of examination methodologies and diagnostics
Proficiency in common medication indications, side effects, and contraindications
Confidence with clinical decision making over telephone visit
All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Compensation for this specialty generally ranges from $104,500 - $156,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
$104.5k-156k yearly 7d ago
Manager, Member and Administrative Operations, Remote in WA
Unitedhealth Group 4.6
Remote or Seattle, WA job
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together
The Member and Administrative Operations Leader is responsible for overseeing all elements of the Health Plan member experience along with assigned administrative functions including policies and procures, audit readiness, contract compliance and business continuity. While the role will give preference to candidates living in Washington and familiar with Washington Medicaid programs, this is not a requirement. This position will require limited travel to Washington (10%).
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Washington preferred. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
Member Operations Leadership:
Lead a team of professionals primarily focused on member and provider materials
Create and execute the member experience strategy. This includes maintaining awareness of current member sentiment, creating strategies to improve experience within budget limitations, collaborating across the health plan and UHG enterprise to execute that strategy, and monitoring outcomes to adjust future iterations of the plan
Maintain situational awareness of local market factors that may impact members and create and implement member engagement strategies to address
Responsible for state required reporting on a monthly, quarterly and annual basis
Create new solutions to address difficult and long-standing challenges in improving health care outcomes including development and oversight of value added benefits
Oversee value added benefits (VABs) for Washington Medicaid. Maintain awareness of market dynamics and member needs. Understand and communicate strategic advantage of VABs. Advocate to leadership for VABs. Partner with national procurement teams to implement VABs. Track utilization of VABs
Set priorities to ensure task completion and performance goals are met for Enrollment Services
Oversee member call center functions and member materials creation and execution, including member handbook, ID card, welcome kit materials and member website
Communicate any observed enrollment issues to Washington Health Care Authority (HCA) state partners and ensure the adoption of policies, processes and best practices required for success
Partner with UHC policy team to create member experience and enrollment advocacy strategy. Represent that strategy directly to HCA and equip other Health Plan leaders to do so
Maintain awareness of all contract elements related to member experience and create and execute business plans to manage those requirements
Responsible for all elements of member materials, including creation, HCA approval, and publication. Responsible for selected provider materials, including, but not limited to Provider Manuals
Administrative Operations Leadership:
Oversee Health Plan Policy and Procedure committee and process
Represent Health Plan in regulatory audits for assigned business areas
Partner with enterprise resiliency team to oversee Health Plan Business Continuity requirements, including simulation facilitation, recovery team contact testing, and completion of related HCA reports
Partner with Compliance Officer and COPA Director to lead Health Plan leaders in the creation and maintenance of contract compliance business plans
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
5+ years of Medicaid experience
3+ years project management or strategy development and execution
2+ years representing Health Plan to regulators, such as HCA or other Medicaid agencies
1+ years of supervisory/leadership experience with direct responsibility for managing performance of employees
Proficiency with MS Office, which includes the ability to navigate and learn new and complex computer system applications
Solid history of quickly gaining credibility, partnering with business leaders and exhibiting executive presence
Proven ability to articulate business strategies and formulate concise solutions to complex problems
Ability to travel to Washington periodically (no more than 4 times annually)
Preferred Qualification:
Resident of Washington and familiarity with Washington Medicaid
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
$56k-69k yearly est. 2d ago
Chief Development Officer (CDO)/ Hybrid
Feeding America 4.3
Remote or New York, NY job
To support City Harvest's next phase of growth, the organization created the new executive position of Chief Development Officer (CDO). The CDO will report directly to the CEO and serve as a core member of the Executive Leadership Team and work closely with the Board of Directors to develop and lead an ambitious, forward-looking fundraising strategy. The CDO will be a key thought partner to the CEO and the central figure in ensuring that City Harvest's development program meets the organization's operational capacity and keeps pace with community needs going forward.
Responsibilities
Oversee the revenue channels of major gifts, principal gifts, and institutional partnerships (foundations and government) as well as development communications and development operations.
Lead a corresponding team of approximately 24, including the Vice President of Development.
Collaborate closely with the Chief External Relations Officer to form a powerful advancement function and ensure coordination with teams responsible for direct response fundraising, business partnerships, and enterprise-wide marketing and communications, special events, and volunteer programs.
Develop and execute a fundraising strategy focused on generating significant, sustainable revenue growth, particularly from high-net-worth individuals and major philanthropic institutions.
Qualifications
Strong connection to City Harvest's mission and broader efforts to address food insecurity.
Minimum of 15 years of progressively responsible experience in nonprofit development, with at least 10 years in a senior leadership role.
Demonstrated success in securing major and principal gifts ($1M+) from high-net-worth individuals and institutions.
Proven experience managing annual fundraising goals of $30 million or more.
Exceptional relationship-building and interpersonal skills, with an ability to build trust with donors, colleagues, and stakeholders at all levels.
Knowledge of the major players, strategies, and trends in giving within New York City's philanthropic community as well as demonstrated fundraising success therein.
Track record of managing, mentoring, and retaining high-performing fundraising teams.
Excellent public speaking, writing, and communication skills.
Experience working with boards and engaging them in fundraising strategy and initiatives.
Strong familiarity with donor management systems and fundraising analytics.
Benefits
Competitive Salary
Generous time off
Full benefits (medical, dental, vision) with employer contributions towards premiums
Employer-provided life insurance
403(b) retirement savings plan with employer matching
Professional development opportunities
Free mental health services with BetterHelp
Commuter benefits
Discounted staff perks (e.g., movie tickets, gym memberships, cellular plans)
Deadline
March 31, 2026
How to apply
City Harvest has retained the DSG Fundraising & Advancement Practice of DSG Global to assist in this search process. Inquiries, nominations, and applications (current resumes and cover letters) may be submitted via the following link:
About City Harvest
City Harvest is New York's first and largest food rescue organization, collecting perfectly good food that would otherwise go to waste and delivering it, free of charge, to help feed the millions of New Yorkers who are struggling to put meals on their tables. In over 40 years of serving neighbors experiencing food insecurity, City Harvest has rescued and delivered more than 1 billion pounds of food for neighbors in need. City Harvest is recognized as a leading equity-driven organization that works alongside its partners to rescue nutritious food and deliver it for free to our neighbors, offers free nutrition and culinary education programming, and advocates in order to strengthen the local food system. City Harvest is committed to being there to provide food to all New Yorkers experiencing food insecurity today and to those who may need assistance in years to come.
Additional information
City Harvest has retained the DSG Fundraising & Advancement Practice of DSG Global to assist in this search process. Inquiries, nominations, and applications (current resumes and cover letters) may be submitted via the following link:
#J-18808-Ljbffr
$50k-67k yearly est. 5d ago
Underwriting Consultant - Remote
Unitedhealth Group 4.6
Remote or Minnetonka, MN job
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together
The Underwriting Consultant will analyze health benefit plan characteristics and assess risks within our underwriting guidelines to meet financial targets. This individual will analyze health benefit plan characteristics and assess risks in developing premiums. Will utilize established underwriting criteria and policies to provide proper rating methodologies. Will assist in maintaining pricing models to assist in the analysis of determining premiums. The Underwriting Consultant will evaluate and recommend alternative pricing options and plan design changes based on economic analysis and trends. This individual will also prepare financial modeling for budget calculation, and other ongoing reviews that directly aligns with client strategies. They will validate renewals and request for proposals for accuracy including utilization & experience reporting.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
Prepare financial experience rating calculations and other ongoing financial reviews that directly aligns with client strategies
Validate renewals and request for proposals for accuracy including utilization and experience reporting
Evaluate and negotiate potential alternatives and options for New Business and Renewal groups with internal and external customers
Collaborate with the Sales and Account Management teams to project pricing and profitability and participate in the development of the business strategy
Support all requests associated with designated account(s) including annual renewal preparation, ad-hoc reporting, consultation, etc.
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
5+ years of experience in healthcare underwriting for any variety of products: PPO, HMO, self-funded, ASO/fully-insured, group or individual
Intermediate level of proficiency with MS Office suite (including Word, Excel and PowerPoint)
Preferred Qualifications:
Experience working with Medicare products including Part D
Proven excellent communication skills, both orally and in writing and solid negotiation skills
Proven solid analytical, problem solving and critical decision-making skills
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
$72.8k-130k yearly 5d ago
Actuarial Consultant, UHG Trend Analytics Team - Remote - Eden Prairie, MNpreferred
Unitedhealth Group 4.6
Remote or Eden Prairie, MN job
UnitedHealth Group is a health care and well-being company that's dedicated to improving the health outcomes of millions around the world. We are comprised of two distinct and complementary businesses, UnitedHealthcare and Optum, working to build a better health system for all. Here, your contributions matter as they will help transform health care for years to come. Make an impact with a diverse team that shares your passion for helping others. Join us to start Caring. Connecting. Growing together.
The Actuarial Consultant will be a vital contributor to the UHG Trend Analytics team, focused on supporting Optum Health with medical expense reporting, analytics and forecasting. This role is responsible for developing and executing quarterly medical expense reporting and forecasting processes that enhance consistency, transparency, and collaboration across UnitedHealth Group. The ideal candidate will have at least 4 years of actuarial experience, strong analytical skills, and a keen interest in driving best-in-class trend methodologies.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.
Primary Responsibilities:
The Consultant in this role will work with detailed healthcare claims data to build and maintain actuarial models to support medical expense reporting and forecasting.
Develop and run quarterly medical expense reporting and/or forecasting processes using standardized actuarial trend methods
Support ongoing enhancements to reporting and forecast accuracy, transparency, and consistency across the enterprise
Analyze large healthcare datasets to identify cost trends, variances, and emerging patterns
Collaborate with cross-functional teams-including finance, operations, and other analytics groups-to ensure alignment in medical expense drivers and against forecast expectations
Prepare and communicate clear and concise reports and presentations for business stakeholders
Contribute to process improvements and automation initiatives
Support ad-hoc analytic requests related to medical cost trend analysis
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
Bachelor's degree in Actuarial Science, Mathematics, Statistics, or related field
Progress toward Associate of the Society of Actuaries (ASA) credential
4+ years of actuarial experience
Experience analyzing large claim data sets
Familiarity with standard actuarial trend methods
Intermediate or higher level of proficiency in Excel (including extensive experience with VBA)
Basic or higher level of proficiency in SAS and SQL
Proven solid written and verbal communication skills; ability to present findings effectively
Preferred Qualifications:
Experience with medical expense forecasting or financial reporting in a payer/provider environment
Experience in healthcare or managed care environments
Experience in Healthcare Consulting
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
#UHCPJ
$56k-72k yearly est. 1d ago
Manager of Clinical Quality - Remote - Rhode Island
Unitedhealth Group 4.6
Remote or Warwick, RI job
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
If you are located within commutable distance of Warwick, RI, you will have the flexibility to work remotely* as you take on some tough challenges. Travel is required about 10% of the time in Rhode Island.
Primary Responsibilities:
Oversee and manage health Plan Accreditation (e.g., trilogy documents such as program description, workplan, evaluation)
Oversee and manage health equity accreditation (e.g., action plan, evaluation)
Develop and oversee future accreditations
Develop, implement and maintain policies and procedures
Oversee and manage member and provider newsletters/ handbooks to ensure they are continuing to meet NCQA guidelines
Work with external vendor to conduct provider access surveys. Analyze results and develop mitigation plans
Review and coordinate approvals for clinical practice guidelines
Monitor and present on provider credentialing and recredentialing
Oversee and manage quality committees (e.g., PAC, CAC, QMC). This includes prep and post calls, agenda and meeting materials, meeting minutes, and etc.
Oversee and manage state reporting and submissions (e.g., QIPs/ CAHPS/ etc.)
Meet and present quality information regularly to state partners and UHC Board of Directors
Oversee and manage provider and member facing programs at the RI level
Develop and maintain positive relationships external state organizations within the scope of Quality Improvement
Oversee and manage state audits (e.g., EQRO)
Develop and get state approval for member and provider facing materials
Coordinate work within C&S quality (i.e., local, regional and national) in order to improve performance and to close gaps in care
Collaborate across business segments to achieve goals and targets
Other activities as they may apply
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
3+ years experience with HEDIS and NCQA - this includes HEDIS and or NCQA project experience including audit and project management of the submissions to the state and NCQA
3+ years of experience with health plan accreditations such as health plan, health equity, health equity plus and long term services and supports distinction
3+ years of experience with outside audit organizations such as EQROs
3+ years of QI project experience with QIP and PIPs (quality improvement projects)
Leadership experience (e.g., Review work of others, Serve as an expert in their field, Serve as a mentor and leader, Lead functional or segment teams or projects, Motivate and inspire team members)
Experience with managed care and insurance industry
Experience in writing reports and analyzing performance data
Experience creating detailed reports and project management
Ability to travel 10% of the time in Rhode Island
Resides within commutable distance of the Rhode Island office
Preferred Qualifications:
Certified Professional in Healthcare Quality (CPHQ) certification
3+ years demonstrated management experience with responsibility for team performance management
Quality improvement experience within a health plan
Clinical experience / background
Experience with corrective action plans
Performance driven
Ability to make independent decisions
Change management experience and demonstrated skills
Demonstrated staff development skills
Solid team building, collaboration and motivational skills
Results-oriented
Ability to work in a fast-paced environment
Experience with excel (working with pivot tables) and creating PPT presentations
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
$89.9k-160.6k yearly 4d ago
Behavioral Health Care Advocate - After Hours Crisis - Remote CA
Unitedhealth Group 4.6
Remote or Los Angeles, CA job
**Premium pay offered for evenings, overnights, weekends, and holidays**
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
You have high standards. So do we. Here at UnitedHealth Group, this includes offering an innovative new standard for care management. It goes beyond counseling services and verified referrals to programs integrated across the entire continuum of care. That means you'll have an opportunity to make an impact on a huge scale - as part of an incredible team culture that's defining the future of behavioral health care.
For this role you must have an active and unrestricted license in your state of residence and you must be able to work nights, weekends and holidays.
If you are located in California, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities:
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
Assess patients and determining appropriate levels of care based on medical necessity
Assess and manage member crisis calls
Determine if additional clinical treatment sessions are needed
Manage inpatient mental health cases throughout the entire treatment plan
Identify ways to add value to treatment plans and consulting with facility staff
Attend compliance training and team meeting
You'll find the pace fast and the challenges ongoing. We'll expect you to achieve and document measurable results. You'll also need to think and act quickly while working with a diverse member population.
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
Independent, Licensed Master's degree in Psychology, Social Work, Counseling or Marriage or Family Counseling, OR Licensed Ph.D., OR an RN with 2+ years of experience in behavioral health
Residence and licenses must be independent, active and unrestricted in the State of California
Proficient Microsoft skills (Word, Excel, Outlook)
Proven ability to talk and type at the same time and have the ability to navigate between multiple screens
Proven ability to work nights, weekends and holidays according to your schedule
Preferred Qualifications:
Inpatient experience
Dual diagnosis experience with mental health and substance abuse
Experience working in an environment that required coordination of benefits and utilization of multiple groups and resources for patients
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Zippia gives an in-depth look into the details of American Medical Response, including salaries, political affiliations, employee data, and more, in order to inform job seekers about American Medical Response. The employee data is based on information from people who have self-reported their past or current employments at American Medical Response. The data on this page is also based on data sources collected from public and open data sources on the Internet and other locations, as well as proprietary data we licensed from other companies. Sources of data may include, but are not limited to, the BLS, company filings, estimates based on those filings, H1B filings, and other public and private datasets. While we have made attempts to ensure that the information displayed are correct, Zippia is not responsible for any errors or omissions or for the results obtained from the use of this information. None of the information on this page has been provided or approved by American Medical Response. The data presented on this page does not represent the view of American Medical Response and its employees or that of Zippia.
American Medical Response may also be known as or be related to American Medical Response, American Medical Response Inc and American Medical Response, Inc.