Advocate jobs at Centene

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. *M-F 8-5 EST/CST* *Partnerships In Care Program* Position Purpose: Performs reviews of member's care and health status of Applied Behavioral Analysis (ABA) services provided to determine medical appropriateness. Monitors clinical effectiveness and efficiency of member's care in accordance with ABA guidelines. Evaluates member's care and health status before, during, and after provision of Applied Behavioral Analysis (ABA) services to ensure level of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder needs and clinical standards Performs prior authorization reviews related to BH to determine medical appropriateness in accordance with ABA regulatory guidelines and criteria Analyzes BH member data to improve quality and appropriate utilization of services Interacts with BH healthcare providers as appropriate to discuss level of care and/or services provided to members receiving Applied Behavior Analysis Services Provides education to members and their families regrading ABA and BH utilization process Provides feedback to leadership on opportunities to improve care services through process improvement and the development of new processes and/or policies Performs other duties as assigned. Complies with all policies and standards. *M-F 8-5 EST/CST* *Partnerships In Care Program* Education/Experience: Requires Graduate of an Accredited School of Nursing or Bachelor's degree and 2-4 years of related experience. For Enterprise Population Health 2+ years providing ABA services as a BCBA License to practice independently, and/or have obtained the state required licensure as outlined by the applicable state (BCBA) required. Master's degree for behavioral health clinicians required. Behavioral health clinical knowledge and ability to review and/or assess ABA Treatment Plans required. Knowledge of ABA services and BH utilization review process required. Experience working with providers and healthcare teams to review care services related to Applied Behavior Analysis Services preferred. License/Certification: LCSW- License Clinical Social Worker required or LMHC-Licensed Mental Health Counselor required or LPC-Licensed Professional Counselor required or Licensed Marital and Family Therapist (LMFT) required or Licensed Mental Health Professional (LMHP) required or Board Certified Behavior Analyst (BCBA) required RN - Registered Nurse - State Licensure and/or Compact State Licensure RN - Registered Nurse- State Licensure and/or Compact State Licensure with BCBA required or Independent licensure with ABA experience and BCBA preferred. preferred Licensed Behavior Analyst (LBA) where required by state required Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

At Luminare Health , our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job SummaryBenefit Advocates are responsible for managing and coordinating a high volume of service requests (phone, emails, portal, chat) from employees (and their immediate family) of our clients. The position focuses on educating and assisting callers with understanding, navigating through and obtaining the maximum value of their healthcare and wellness benefits, and employee incentive programs provided by their employers. Benefit Advocates assist employees to understand their benefit plan offering, and provide direction in working through a variety of benefit issues. **Please note this role is for the 12pm-8pm (cst) shift. Some weekends and holidays will be required** Required Job Qualifications: High School diploma or GED equivalent Minimum one year of insurance and/or benefits customer service experience Ability to effectively organize and prioritize work demands in a dynamic, fast-paced environment Ability to continuously display a positive attitude and follow directions Possess excellent customer service skills including proper grammar, tonalities and clear dictation Proficient in Microsoft Office Suite, data entry and electronic mail applications Excellent written and verbal communication skills, including the ability to adapt communication style to persons representing diverse personal, professional, cultural and socio-economic backgrounds Must be able to work a flexible 37.5 hour work week in a 24/7/365 call center environment - some 3rd shift, evenings, weekends, and holidays will be required Ability to sit and use the phone for long periods of time Preferred Job Qualifications: Associates Degree Bilingual in Spanish/English EBS, PHR, SPHR or CBP certification Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! EEO Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. Pay Transparency Statement: At Luminare, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for associates. The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. Min to Max Range: $14.68 - $27.57 Exact compensation may vary based on skills, experience, and location.

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 Surest, we are passionate about improving the health of our members! The Clinical Advocate- Renal is responsible for supporting Surest members throughout their health journey to assess needs, educate and provide resources. The Clinical Advocate - Oncology will also focus on members with oncology questions and concerns and screen for health and social determinant issues. This position reports to the Clinical Operations Manager and has no direct reports. If you reside within PST time zone, you will have the flexibility to work remotely* as you take on some tough challenges. **Primary Responsibilities:** + Engage with Surest members telephonically and by email to identify needs and assist with benefit navigation, decision support and general oncology information + Educate on the Surest plan benefit, provide resources and healthcare decision support with members + Screen for high-risk situations, including health and SDOH, and refer to appropriate sources + Establish trust with members + Track, assess and document member's health plan + Identify high risk situations early and support members proactively to improve outcomes + Cross trained to assist with other disease/condition focused needs for the member + Provide expert consultation to other Clinical Advocates on the team or other business units about renal disease and other member's needs + Identify and execute on process improvement opportunities + Personal development + Team engagement and connecting + Other Surest/UHG activities and development 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 LPN license OR Medical Assistant certification + 2+ years of clinical experience in a hospital, acute care, direct care, rehab facility or care coordination + 2+ years of clinical experience in Oncology field + Experience with Motivational Interviewing + Proven experience working in a fast paced multitask environment + Proficiency with MS Office- Word, Excel, Outlook, Teams + Proven excellent communication skills- both written and verbal + Proven to excel working in a constantly rapid changing environment + Reside in the PST time zone to support 8:00 - 5:00 member base (OR willing to work 8-5 PST schedule) **Preferred Qualifications:** + Bachelor's Degree in health - related specialty + Comfortable questioning status quo and proposing ideas for improvement + Bi-lingual *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy \#Programmatic 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._

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 Surest, we are passionate about improving the health of our members! The Clinical Advocate- Renal is responsible for supporting Surest members throughout their health journey to assess needs, educate and provide resources. The Clinical Advocate - Oncology will also focus on members with oncology questions and concerns and screen for health and social determinant issues. This position reports to the Clinical Operations Manager and has no direct reports. If you reside within PST time zone, you will have the flexibility to work remotely* as you take on some tough challenges. **Primary Responsibilities:** + Engage with Surest members telephonically and by email to identify needs and assist with benefit navigation, decision support and general oncology information + Educate on the Surest plan benefit, provide resources and healthcare decision support with members + Screen for high-risk situations, including health and SDOH, and refer to appropriate sources + Establish trust with members + Track, assess and document member's health plan + Identify high risk situations early and support members proactively to improve outcomes + Cross trained to assist with other disease/condition focused needs for the member + Provide expert consultation to other Clinical Advocates on the team or other business units about renal disease and other member's needs + Identify and execute on process improvement opportunities + Personal development + Team engagement and connecting + Other Surest/UHG activities and development 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 LPN license OR Medical Assistant certification + 2+ years of clinical experience in a hospital, acute care, direct care, rehab facility or care coordination + 2+ years of clinical experience in Oncology field + Experience with Motivational Interviewing + Proven experience working in a fast paced multitask environment + Proficiency with MS Office- Word, Excel, Outlook, Teams + Proven excellent communication skills- both written and verbal + Proven to excel working in a constantly rapid changing environment + Reside in the PST time zone to support 8:00 - 5:00 member base (OR willing to work 8-5 PST schedule) **Preferred Qualifications:** + Bachelor's Degree in health - related specialty + Comfortable questioning status quo and proposing ideas for improvement + Bi-lingual *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy \#Programmatic 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._

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 Surest, we are passionate about improving the health of our members! The Clinical Advocate- Renal is responsible for supporting Surest members throughout their health journey to assess needs, educate and provide resources. The Clinical Advocate - Oncology will also focus on members with oncology questions and concerns and screen for health and social determinant issues. This position reports to the Clinical Operations Manager and has no direct reports. If you reside within PST time zone, you will have the flexibility to work remotely* as you take on some tough challenges. **Primary Responsibilities:** + Engage with Surest members telephonically and by email to identify needs and assist with benefit navigation, decision support and general oncology information + Educate on the Surest plan benefit, provide resources and healthcare decision support with members + Screen for high-risk situations, including health and SDOH, and refer to appropriate sources + Establish trust with members + Track, assess and document member's health plan + Identify high risk situations early and support members proactively to improve outcomes + Cross trained to assist with other disease/condition focused needs for the member + Provide expert consultation to other Clinical Advocates on the team or other business units about renal disease and other member's needs + Identify and execute on process improvement opportunities + Personal development + Team engagement and connecting + Other Surest/UHG activities and development 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 LPN license OR Medical Assistant certification + 2+ years of clinical experience in a hospital, acute care, direct care, rehab facility or care coordination + 2+ years of clinical experience in Oncology field + Experience with Motivational Interviewing + Proven experience working in a fast paced multitask environment + Proficiency with MS Office- Word, Excel, Outlook, Teams + Proven excellent communication skills- both written and verbal + Proven to excel working in a constantly rapid changing environment + Reside in the PST time zone to support 8:00 - 5:00 member base (OR willing to work 8-5 PST schedule) **Preferred Qualifications:** + Bachelor's Degree in health - related specialty + Comfortable questioning status quo and proposing ideas for improvement + Bi-lingual *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy \#Programmatic 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._

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 Surest, we are passionate about improving the health of our members! The Clinical Advocate- Renal is responsible for supporting Surest members throughout their health journey to assess needs, educate and provide resources. The Clinical Advocate - Oncology will also focus on members with oncology questions and concerns and screen for health and social determinant issues. This position reports to the Clinical Operations Manager and has no direct reports. If you reside within PST time zone, you will have the flexibility to work remotely* as you take on some tough challenges. **Primary Responsibilities:** + Engage with Surest members telephonically and by email to identify needs and assist with benefit navigation, decision support and general oncology information + Educate on the Surest plan benefit, provide resources and healthcare decision support with members + Screen for high-risk situations, including health and SDOH, and refer to appropriate sources + Establish trust with members + Track, assess and document member's health plan + Identify high risk situations early and support members proactively to improve outcomes + Cross trained to assist with other disease/condition focused needs for the member + Provide expert consultation to other Clinical Advocates on the team or other business units about renal disease and other member's needs + Identify and execute on process improvement opportunities + Personal development + Team engagement and connecting + Other Surest/UHG activities and development 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 LPN license OR Medical Assistant certification + 2+ years of clinical experience in a hospital, acute care, direct care, rehab facility or care coordination + 2+ years of clinical experience in Oncology field + Experience with Motivational Interviewing + Proven experience working in a fast paced multitask environment + Proficiency with MS Office- Word, Excel, Outlook, Teams + Proven excellent communication skills- both written and verbal + Proven to excel working in a constantly rapid changing environment + Reside in the PST time zone to support 8:00 - 5:00 member base (OR willing to work 8-5 PST schedule) **Preferred Qualifications:** + Bachelor's Degree in health - related specialty + Comfortable questioning status quo and proposing ideas for improvement + Bi-lingual *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy \#Programmatic 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._

**Become a part of our caring community and help us put health first** The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Care Manager, Telephonic Behavioral Health 2 is a **Licensed, Masters level, Social Worker** who functions as a Support Social Services associate (Support SS) in our Special Needs Plan (SNP) program and serves as part of an interdisciplinary care team member working with other disciplines, such as nurse care managers, dieticians, behavioral health, and pharmacists to help promote and support member health and well-being. This role requires the use of structured assessments along with critical thinking skills to determine appropriate interventions such as care coordination, health education, connection to community resources, full utilization of benefits and advocacy. This role requires effective and professional communication with providers, community resources, and other members of the interdisciplinary team to address member needs. The Support SSs daily job duties include making outbound call attempts to members with social determinants of health (SDOH) needs to assess and assist with coordinating care with available plan benefits and/or appropriate community resources in a telephonic, call center, work from home environment. This role does not carry a caseload but may require additional member follow-up to ensure that all needs have been assessed and addressed. The Support SS may also receive inbound calls from members needing additional assistance. This role is also responsible for assessing the member to determine if a referral to any other discipline is needed depending on member's individualized needs. Creating and updating member care plans may be required. Documentation in the member's record is required to ensure CMS compliance, and accurately reflect work with members, providers, and other members of the interdisciplinary care team. **Use your skills to make an impact** **Required Qualifications** + Master's degree in social work from an accredited university + Current, unincumbered, social work license; **LMSW, LCSW, LICSW** + Must have passed ASWB Exam (Master, Advance Generalist, or Clinical level) + Minimum 3 years of experience working as a social worker in a medical healthcare setting + Proficient in Microsoft applications including Word, Outlook, Excel + Capacity to manage multiple or competing priorities including use of multiple computer applications simultaneously + Must be willing to obtain/maintain social work licensure in multiple states, based on business need **Preferred Qualifications** + Experience working with geriatric, vulnerable, and/or low-income populations + Licensure in LA, MD, MI, MS, NV, NM, OK, VA + Bilingual English/Spanish + Bilingual English/Creole + Experience working with Medicare and Medicaid **Additional Information** **Work-At-Home Requirements:** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. **Social Security Notification:** Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. **HireVue Interview Process:** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. **Benefits Day 1:** Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including: Health benefits effective day 1 Paid time off, holidays, volunteer time and jury duty pay Recognition pay 401(k) retirement savings plan with employer match Tuition assistance Scholarships for eligible dependents Parental and caregiver leave Employee charity matching program Network Resource Groups (NRGs) Career development opportunities **START DATE after completion of background/onboarding-** *Projected start dates for these positions will be throughout Feb 2026 with all interviews being conducted Dec/Jan **Schedule:** + Hours for this position are Monday - Friday 9:30am - 6pm EST. + Hours for the first 2 weeks of training are M-F 8:30am-5pm EST Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $59,300 - $80,900 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-21-2025 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

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 Surest, we are passionate about improving the health of our members! The Clinical Advocate- Renal is responsible for supporting Surest members throughout their health journey to assess needs, educate and provide resources. The Clinical Advocate - Oncology will also focus on members with oncology questions and concerns and screen for health and social determinant issues. This position reports to the Clinical Operations Manager and has no direct reports. If you reside within PST time zone, you will have the flexibility to work remotely* as you take on some tough challenges. **Primary Responsibilities:** + Engage with Surest members telephonically and by email to identify needs and assist with benefit navigation, decision support and general oncology information + Educate on the Surest plan benefit, provide resources and healthcare decision support with members + Screen for high-risk situations, including health and SDOH, and refer to appropriate sources + Establish trust with members + Track, assess and document member's health plan + Identify high risk situations early and support members proactively to improve outcomes + Cross trained to assist with other disease/condition focused needs for the member + Provide expert consultation to other Clinical Advocates on the team or other business units about renal disease and other member's needs + Identify and execute on process improvement opportunities + Personal development + Team engagement and connecting + Other Surest/UHG activities and development 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 LPN license OR Medical Assistant certification + 2+ years of clinical experience in a hospital, acute care, direct care, rehab facility or care coordination + 2+ years of clinical experience in Oncology field + Experience with Motivational Interviewing + Proven experience working in a fast paced multitask environment + Proficiency with MS Office- Word, Excel, Outlook, Teams + Proven excellent communication skills- both written and verbal + Proven to excel working in a constantly rapid changing environment + Reside in the PST time zone to support 8:00 - 5:00 member base (OR willing to work 8-5 PST schedule) **Preferred Qualifications:** + Bachelor's Degree in health - related specialty + Comfortable questioning status quo and proposing ideas for improvement + Bi-lingual *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy \#Programmatic 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._

The Optum family of businesses, is seeking a Behavioral Health Case Manager to join our team in Missouri. As a member of the Optum Behavioral Care team, you'll be an integral part of our vision to make healthcare better for everyone. The Behavioral Health Case Manager will provide telephonic and in-person support for both direct referrals and data identified referrals. This requires clinical expertise and the ability to negotiate the complexities involved with special needs conditions such as substance use, suicidality/homicide, major depression, ADHD, eating disorders, and severe mental illness. This position may require minimal field work to meet with members at local facilities in the future. Primary Responsibilities: * Facilitate member education and involvement of caregiver in the delivery of interventions * Provide advocacy and support to member and family members, including caregiver support & appropriate referral to applicable / needed resources * Ensure that members understand treatment options and are effectively linked to treatment resources * Promote health, wellness and optimal psychosocial functioning for member (identify caregiver gaps, facilitate education and respite support) * Consider the member's needs holistically to identify gaps in care requiring intervention * Exhibit excellent customer service in engaging providers in collaborative planning * Create and maintain appropriate clinical records * Participate as directed in clinical rounds with other members of the team and other external health care management organizations / vendors, as applicable. Also participate in advancing the Quality Improvement Program * Conduct condition specific research to meet member needs * Maintain success stories which can be utilized to promote program * Provide case management support for individuals who meet diagnostic requirements including engagement of member and/ or family making available support throughout the entire continuum of treatment * Explanation of authorization process * Complete discharge follow-up & if needed, discharge planning / support 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 in Psychology, Social Work, Counseling, or Marriage and Family Counseling or Licensed Ph.D. * Active, unrestricted clinical license to practice independently without supervision in the state of Missouri * 2+ years of post-licensure experience in a related mental health environment * 1+ years of case management experience * Proven intermediate level computer skills including proficiency with MS Office Suite * Access to high-speed internet (Broadband Cable, DSL, Fiber) and a dedicated workspace at home * Reside in Missouri Preferred Qualifications: * Hospital experience including intakes, assessments, discharge planning, and/or case management * Community mental health experience including case management * Experience doing chart reviews * Experience consulting with facility and/or hospital staff to coordinate treatment plans * 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 * Experience with government funded programs Explore opportunities at Optum Behavioral Care. We're revolutionizing behavioral health care delivery for individuals, clinicians and the entire health care system. Together, we are bringing high-end medical service, compassionate care and industry leading solutions to our most vulnerable patient populations. Our holistic approach addresses the physical, mental and social needs of our patients wherever they may be - helping patients access and navigate care anytime and anywhere. We're connecting care to create a seamless health journey for patients across care settings. Join our team, it's your chance to improve the lives of millions while Caring. Connecting. Growing together. 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. 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.

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.** 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. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. 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 + 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 **Preferred Qualifications:** + 2+ years of child and family experience + Experience supporting members in an inbound call center + 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. **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._

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._

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.** **UnitedHealthcare Community & State Senior Care Options plan** is a Fully Integrated Dual-Special Needs Plan (FIDE-SNP) serving dually eligible individuals in the Commonwealth of Massachusetts aged 65 or greater. This position reports to the Health Services Director in the Health Services Department within the Senior Care Options Plan. This position sets team direction, resolves problems and provides direction to nurse case managers. This position adapts departmental plans and priorities to address business and operational challenges such as staffing, the clinical model and inter-departmental actions and goals. 10% of expected travel within Massachusetts. If you reside near Worcester, MA, you will enjoy the flexibility to telecommute* as you take on some tough challenges." **Primary Responsibilities:** **Leadership:** + Supervises a team that varies in size based upon Capacity Plans and staffing models. Direct reports are located at same site, at home or at a remote UHC site + Hires, manages and develops new employees and proactively monitors individual and team performance by providing frequent, ongoing feedback and coaching + Implement strategies to improve operational performance, quality and delivery service to constituents + Leads regular team meetings to communicate changes, relevant operational performance information and/or to build employee engagement + Utilizes Our United Culture concepts and tools and delivers on the commitments + Demonstrates a positive leadership shadow by shaping positive behaviors in areas of influence, building integrity, influencing our values and creating a healthy, high-performance environment **Drive Effective Clinical Decisions within a Business Environment:** **Operational Performance:** + Develops and/or implements bottoms-up strategies to improve operational performance + Continually stays abreast of operational performance, identifies degradation in service levels and leads to remediation of issues + Responsible for the interview and selection decisions on new hire staffing within their own hierarchy + Accountable for a successful new hire onboarding experience + Responsible for creating a positive and meaningful onboarding experience for all employees + Delivers and documents one-on-one coaching to improve all aspects of performance and effectiveness + Completes "side-by-side" monitoring/coaching with direct reports on a regular basis + As needed, prepares, delivers and manages remediation plans + Participate in job fairs, open houses and other recruitment events as needed + Ensure compliance with Model of Care and State contractual requirements (Chart audits) + Utilize evidence-based guidelines (e.g., medical necessity guidelines, practice standards, industry standards, best practices, and contractual requirements) to make clinical decisions, improve clinical outcomes and achieve business results + Use appropriate business metrics (e.g. member/FTE, length of stay, readmission rates, STAR ratings, member engagement rates) and applicable processes/tools (e.g. cost benefit analysis, return on investment, performance, staffing calculator) to optimize decisions and clinical outcomes + Prioritize work based on business algorithms and established work processes, or in their absence, identify business priorities and build consensus to triage and deliver work (e.g. assessments, case/claim loads, previous hospitalizations, acuity, morbidity rates, quality of care follow up) + Understand and operate effectively/efficiently within legal/regulatory requirements (e.g., HIPAA, CMS, State) **Coaching & Performance Management:** + Communicate with direct reports on a regular basis through coaching sessions and by providing timely, actionable feedback + Ensures performance metrics and goals are reviewed on a regular and frequent basis, with time set aside for incidental issues + Provides purposeful and actionable development feedback to direct reports and monitors to support their performance improvement + If, after the action items of the development plan do not yield the desired positive results in the agreed upon timeframe, CAP is initiated in accordance with UHG policies and practices + Works with HRdirect on disciplinary actions or terminations and seeks manager approval on all terminations + Tracks and manages attendance and punctuality in a timely and accurate manner **Development & Employee Engagement:** + Prepares and delivers thorough and meaningful performance discussions and documents with data and fact-based examples to reduce ambiguity of ongoing expectations + Creates purposeful and actionable development plans, reviews with employees and monitors to support their performance improvement expectations and development + Engages in regular, meaningful and candid development and career discussions with direct reports + Guides employees to leverage available training and development resources + Analyzes and understands Employee experience survey results and communicates results to team members + Works to establish an action plan to address opportunity areas and improve results + Supports overall organization in employee engagement programs and communications **Communication:** + Holds consistent 1:1meetings with direct reports + Regularly leverages various communication channels, including one-on-ones and new hire class leadership interactions to foster two-way communication. Inspires employees to see the link between their position and personal performance to organizational strategy, company performance and the UHC brand **Demonstrate Business and Industry Knowledge:** + Demonstrate knowledge of computer functionality and software applications (e.g., navigating systems, troubleshooting, electronic charting, accessing intranet and record management databases) + Demonstrate knowledge of relevant state and federal guidelines (e.g., Medicare, Medicaid,) or regulatory bodies (e.g., EOHHS, HIPAA, Milliman) + Demonstrate understanding of relevant health care benefit plans + Demonstrate knowledge of applicable area of clinical specialization + Utilize resources to enhance professional practice and development based on learning gaps or new information 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:** + Unrestricted Nursing license in the state of MA + 5+ years of care management experience and/or 5+ years of equivalent clinical knowledge and experience such as social care, healthcare coordination, quality improvement + 1+ years of experience with SharePoint and shared network drives + Intermediate level of proficiency with Microsoft Office applications, including Word, Excel and PowerPoint + Access to reliable transportation and valid US driver's license **Preferred Qualifications:** + BS / BA Degree + 3+ years of leadership experience + Proven ability to focus activities on a strategic direction and achieve targets + Time management and prioritization skills + Strong written and verbal professional communication skills + Excellent team development skills + Strong interpersonal skills + Ability to work in a self-directed manner in a fast-paced, rapidly changing environment + Demonstrated leadership abilities *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 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._ \#RPO #GREEN

Become a part of our caring community and help us put health first Join Humana as a Case Manager and make a real difference within the Inclusa/Humana team, serving members in the Wisconsin Family Care (FC) program. In this dynamic role, you will collaborate closely with dedicated colleagues to deliver exceptional care and empower our members to thrive in their daily lives. As a Case Manager, you will provide comprehensive social service care management to frail elders and adults with intellectual, developmental, or physical disabilities who qualify for Wisconsin's FC program. Bring your compassion and expertise to help members access vital resources, promote independence, and enhance their quality of life within their communities. Key responsibilities: Assess members to identify their strengths, interests, and preferences, focusing on health and safety needs to develop a comprehensive Member Care Plan (MCP). Coordinate services that address members' health and safety needs, ensuring support is provided in the least restrictive environment in accordance with the MCP. Collaborate continuously with a Field Care Nurse (RN) to review and update care plans and address members' evolving needs. Conduct face-to-face social assessments with members upon enrollment and at minimum, every six months, typically at the member's residence. Schedule, conduct, and document quarterly in-person visits and maintain monthly contact with members by phone. Identify, arrange, and monitor support services for members, including those related to social integration, community resources, employment, housing, and other non-medical needs. Engage in clear and empathetic communication with members to better understand their needs, support informed decision-making, and ensure cost-effective service delivery. Prioritize safety by continuously evaluating risk factors and providing education to members to promote overall health and wellness. Maintain accurate and timely documentation of activities, including case notes, service authorizations, and updates to the Member Care Plan. Foster direct collaboration with service providers, natural supports, and other community partners to enhance member outcomes. Travel is necessary to conduct member visits and fulfill role responsibilities. Use your skills to make an impact Required Qualifications Four-year bachelor's degree in human services or related field with one (1) year of experience working with at least one of the Family Care target populations OR a four-year bachelor's degree in any other field with three (3) years' related experience working with at least one of the Family Care target populations. Demonstrated intermediate computer proficiency, including experience with Microsoft Office applications. ***The Family Care target group population is defined as: frail elders and adults with intellectual, developmental, or physical disabilities*** Preferred Qualifications Case Management experience Experience with electronic case note documentation and experience with documenting in multiple computer applications/systems Knowledge of community health and social service agencies and additional community resources Additional Information Workstyle: This is a field position where employees perform their core duties at non-company locations, such as providing services at business partner facilities or prospects' and members' homes. Work Location: Eau Claire and surrounding areas Travel: up to 40% throughout Eau Claire and surrounding areas. Mileage reimbursement follows our mileage policy. Typical Workdays/Hours: Monday - Friday, 8:00 am - 4:30 pm CST Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $53,700 - $72,600 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us About Inclusa: Inclusa manages the provision of a person-centered and community-focused approach to long-term care services and support to Family Care members across the state of Wisconsin. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity which focuses on the belief in everyone, and from that belief, the common good for all is achieved. In 2022, Inclusa was acquired by Humana. This partnership will allow us to create a model of care that provides industry-leading support for members across the health care continuum.About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Explore opportunities with [agency name], a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of **Caring. Connecting. Growing together.** As the Transitional Case Manager (TCM), you will be facilitating seamless transitions for patients from facility settings to post-acute care. You will verify home health orders, assess care requirements, and ensure continuity of care. Your role includes assessing patients' health literacy, involving patients and families in care planning, and providing education to improve outcomes and promote self-management. You will implement rehospitalization reduction initiatives for patients at risk and communicate with healthcare providers throughout the transition. You'll enjoy the flexibility to work remotely as you take on some tough challenges. **Primary Responsibilities:** + Educate patients on post-discharge follow-up, homebound criteria, and obtaining prescriptions + Assess readmission risk using the LACE tool + Ensure patients and families have agency contact information + Coordinate ancillary services (DME, Infusion) as needed + Assist in preparing for patient care post-discharge + Liaise between the agency and healthcare providers + Communicate patient transfers and coordinate resumption of care + Provide feedback on readmissions and non-admit decisions + Perform other duties as assigned 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, LPN, or SW licensure in state of practice + Current CPR certification + 1+ years home health experience or 1+ years of hospital case management experience + Current driver's license, vehicle insurance, access to a dependable vehicle or public transportation *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 $48,700 to $87,000 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._

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 Escalations Advocate is an individual contributor role responsible for an exciting variety of responsibilities in Specialty Networks of OptumHealth. We are looking for someone with solid analytical skills, who can think critically. The perfect candidate is flexible, detail oriented, able to see the big picture, can work within and across multidisciplinary teams, build relationships and has a positive personality. We are seeking lifelong learners who stay up to date on regulations, industry trends and advancements in the field, in addition to constantly developing their personal skillset. Our team members are sought out as a valued experts by our case partners, accounts, and customers. * Required schedule is Monday-Friday, 10:30am - 7:00pm CST* You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Extensive work experience, possibly in multiple operational areas * Manage a challenging role in a fast - paced environment * Achieve timely resolution to urgent and non - urgent issues, most of our issues turn around in 48hrs * Synthesize and communicate complex information in understandable terms both verbally and written * Support issue resolution for a variety of internal and external customers * Critically analyze issues from multiple angles to determine the root cause and next steps * Analyze issues including conducting a root cause analysis by identifying potential compliance, process, or systemic breakdowns and communicate findings to management and issue resolution partners * Able communicate effectively with state agencies, regulators, external customers, clinical medical directors, and senior leadership * Utilize expertise to support issue resolution * Collaborate and coordinate across multiple teams, departments, and representatives * Recognize trends with escalated issues and identity, carry out or coordinate preventative action * Develop effective working relationships with the applicable internal and external customers * Ability to conduct quick and thorough in-depth research across many systems and platforms (Iset, Linx, Unet, Facets, etc.) * Work independently * Mentor and develop other team members * Hold others accountable for resolution activities * Review the work of others to assess accuracy with process requirements * Develop innovative approaches to issue resolution * Providing member advocacy including serving as a primary point of contact for members who require assistance with their healthcare needs * Reviewing and resolving complex claims issues, investigating claim discrepancies, and collaborating with the claims processing teams * Understanding medical and behavioral health terminology, treatment options, and guidelines 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: * Behavioral Health Clinical licensure - independently clinically licensed (i.e., LPC, LCSW, LMFT, LMHC, etc.). * 5+ years of behavioral health care experience * 3+ years of customer service experience in the healthcare industry * Proven knowledge of or State and Federal regulations that govern commercial health insurance * Proficiency with computer and Windows PC applications * Proficiency with Linx, ICUE, OCM * Designated workspace and access to install secure high-speed internet via cable/DSL in home Preferred Qualifications: * Experience with or a willingness to learn behavioral health appeals/claims * Optum Care Advocacy or UM experience * Assessment and Triage experience * 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. 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.

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 Escalations Advocate is an individual contributor role responsible for an exciting variety of responsibilities in Specialty Networks of OptumHealth. We are looking for someone with solid analytical skills, who can think critically. The perfect candidate is flexible, detail oriented, able to see the big picture, can work within and across multidisciplinary teams, build relationships and has a positive personality. We are seeking lifelong learners who stay up to date on regulations, industry trends and advancements in the field, in addition to constantly developing their personal skillset. Our team members are sought out as a valued experts by our case partners, accounts, and customers. *****Required schedule is Monday-Friday, 10:30am - 7:00pm CST***** You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Extensive work experience, possibly in multiple operational areas + Manage a challenging role in a fast - paced environment + Achieve timely resolution to urgent and non - urgent issues, most of our issues turn around in 48hrs + Synthesize and communicate complex information in understandable terms both verbally and written + Support issue resolution for a variety of internal and external customers + Critically analyze issues from multiple angles to determine the root cause and next steps + Analyze issues including conducting a root cause analysis by identifying potential compliance, process, or systemic breakdowns and communicate findings to management and issue resolution partners + Able communicate effectively with state agencies, regulators, external customers, clinical medical directors, and senior leadership + Utilize expertise to support issue resolution + Collaborate and coordinate across multiple teams, departments, and representatives + Recognize trends with escalated issues and identity, carry out or coordinate preventative action + Develop effective working relationships with the applicable internal and external customers + Ability to conduct quick and thorough in-depth research across many systems and platforms (Iset, Linx, Unet, Facets, etc.) + Work independently + Mentor and develop other team members + Hold others accountable for resolution activities + Review the work of others to assess accuracy with process requirements + Develop innovative approaches to issue resolution + Providing member advocacy including serving as a primary point of contact for members who require assistance with their healthcare needs + Reviewing and resolving complex claims issues, investigating claim discrepancies, and collaborating with the claims processing teams + Understanding medical and behavioral health terminology, treatment options, and guidelines 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:** + Behavioral Health Clinical licensure - independently clinically licensed (i.e., LPC, LCSW, LMFT, LMHC, etc.). + 5+ years of behavioral health care experience + 3+ years of customer service experience in the healthcare industry + Proven knowledge of or State and Federal regulations that govern commercial health insurance + Proficiency with computer and Windows PC applications + Proficiency with Linx, ICUE, OCM + Designated workspace and access to install secure high-speed internet via cable/DSL in home **Preferred Qualifications:** + Experience with or a willingness to learn behavioral health appeals/claims + Optum Care Advocacy or UM experience + Assessment and Triage experience *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. 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._

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. UnitedHealthcare Community & State Senior Care Options plan is a Fully Integrated Dual-Special Needs Plan (FIDE-SNP) serving dually eligible individuals in the Commonwealth of Massachusetts aged 65 or greater. This position reports to the Health Services Director in the Health Services Department within the Senior Care Options Plan. This position sets team direction, resolves problems and provides direction to nurse case managers. This position adapts departmental plans and priorities to address business and operational challenges such as staffing, the clinical model and inter-departmental actions and goals. 10% of expected travel within Massachusetts. If you reside near Worcester, MA, you will enjoy the flexibility to telecommute* as you take on some tough challenges." Primary Responsibilities: Leadership: * Supervises a team that varies in size based upon Capacity Plans and staffing models. Direct reports are located at same site, at home or at a remote UHC site * Hires, manages and develops new employees and proactively monitors individual and team performance by providing frequent, ongoing feedback and coaching * Implement strategies to improve operational performance, quality and delivery service to constituents * Leads regular team meetings to communicate changes, relevant operational performance information and/or to build employee engagement * Utilizes Our United Culture concepts and tools and delivers on the commitments * Demonstrates a positive leadership shadow by shaping positive behaviors in areas of influence, building integrity, influencing our values and creating a healthy, high-performance environment Drive Effective Clinical Decisions within a Business Environment: Operational Performance: * Develops and/or implements bottoms-up strategies to improve operational performance * Continually stays abreast of operational performance, identifies degradation in service levels and leads to remediation of issues * Responsible for the interview and selection decisions on new hire staffing within their own hierarchy * Accountable for a successful new hire onboarding experience * Responsible for creating a positive and meaningful onboarding experience for all employees * Delivers and documents one-on-one coaching to improve all aspects of performance and effectiveness * Completes "side-by-side" monitoring/coaching with direct reports on a regular basis * As needed, prepares, delivers and manages remediation plans * Participate in job fairs, open houses and other recruitment events as needed * Ensure compliance with Model of Care and State contractual requirements (Chart audits) * Utilize evidence-based guidelines (e.g., medical necessity guidelines, practice standards, industry standards, best practices, and contractual requirements) to make clinical decisions, improve clinical outcomes and achieve business results * Use appropriate business metrics (e.g. member/FTE, length of stay, readmission rates, STAR ratings, member engagement rates) and applicable processes/tools (e.g. cost benefit analysis, return on investment, performance, staffing calculator) to optimize decisions and clinical outcomes * Prioritize work based on business algorithms and established work processes, or in their absence, identify business priorities and build consensus to triage and deliver work (e.g. assessments, case/claim loads, previous hospitalizations, acuity, morbidity rates, quality of care follow up) * Understand and operate effectively/efficiently within legal/regulatory requirements (e.g., HIPAA, CMS, State) Coaching & Performance Management: * Communicate with direct reports on a regular basis through coaching sessions and by providing timely, actionable feedback * Ensures performance metrics and goals are reviewed on a regular and frequent basis, with time set aside for incidental issues * Provides purposeful and actionable development feedback to direct reports and monitors to support their performance improvement * If, after the action items of the development plan do not yield the desired positive results in the agreed upon timeframe, CAP is initiated in accordance with UHG policies and practices * Works with HRdirect on disciplinary actions or terminations and seeks manager approval on all terminations * Tracks and manages attendance and punctuality in a timely and accurate manner Development & Employee Engagement: * Prepares and delivers thorough and meaningful performance discussions and documents with data and fact-based examples to reduce ambiguity of ongoing expectations * Creates purposeful and actionable development plans, reviews with employees and monitors to support their performance improvement expectations and development * Engages in regular, meaningful and candid development and career discussions with direct reports * Guides employees to leverage available training and development resources * Analyzes and understands Employee experience survey results and communicates results to team members * Works to establish an action plan to address opportunity areas and improve results * Supports overall organization in employee engagement programs and communications Communication: * Holds consistent 1:1meetings with direct reports * Regularly leverages various communication channels, including one-on-ones and new hire class leadership interactions to foster two-way communication. Inspires employees to see the link between their position and personal performance to organizational strategy, company performance and the UHC brand Demonstrate Business and Industry Knowledge: * Demonstrate knowledge of computer functionality and software applications (e.g., navigating systems, troubleshooting, electronic charting, accessing intranet and record management databases) * Demonstrate knowledge of relevant state and federal guidelines (e.g., Medicare, Medicaid,) or regulatory bodies (e.g., EOHHS, HIPAA, Milliman) * Demonstrate understanding of relevant health care benefit plans * Demonstrate knowledge of applicable area of clinical specialization * Utilize resources to enhance professional practice and development based on learning gaps or new information 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: * Unrestricted Nursing license in the state of MA * 5+ years of care management experience and/or 5+ years of equivalent clinical knowledge and experience such as social care, healthcare coordination, quality improvement * 1+ years of experience with SharePoint and shared network drives * Intermediate level of proficiency with Microsoft Office applications, including Word, Excel and PowerPoint * Access to reliable transportation and valid US driver's license Preferred Qualifications: * BS / BA Degree * 3+ years of leadership experience * Proven ability to focus activities on a strategic direction and achieve targets * Time management and prioritization skills * Strong written and verbal professional communication skills * Excellent team development skills * Strong interpersonal skills * Ability to work in a self-directed manner in a fast-paced, rapidly changing environment * Demonstrated leadership abilities * 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 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. #RPO #GREEN

A great opportunity to help military members and their families! This position is responsible for providing confidential behavioral health consultations and 1-12 fifty minute sessions of non-medical counseling (EAP) to members of the military and their family. Non-medical counseling is focused on a specific issue or concern and includes developing strategies and solutions, building on the participant's strengths, accessing support systems, and utilizing community resources. Sessions are provided telephonically, via video or secure chat and are intended to be solution focused and short-term. Non-medical Counseling topics are varied but often include the following issues: Stress Transition/Relocation Grief and loss Employment issues Marital/couple conflict or communication Parent-Child Relational Problems Academic or Educational problems Problems related to Primary Support The successful candidate will have demonstrated excellence with solution focused therapy with a passion to deliver a service experience that exceeds the participant's expectation. The team works in a fast-paced environment, on a queue, taking non-medical counseling calls in the moment, as well as through scheduled appointments. The team is staffed 24/7 in support of the schedules of miliary members around the world. This role offers a great salary with an excellent benefits package that starts your first day of employment including a continuing education program with funding and extra leave time. Duties and Responsibilities: Provide participants with confidential, non-medical counseling services Assess the participant's immediate risk and biopsychosocial needs Provide appropriate referrals for resources and treatment Use clinical expertise, professional judgment and best practices Execute duty to warn/mandated reporting processes Partner with peers and leaders promoting and embracing a culture of change; supporting all parties through the change process Demonstrate the ability to be agile and flexible in work process. Deliver excellent clinical judgment and interpersonal communication skills Understand confidentiality and privacy regulations Demonstrate excellent verbal and written communication Display knowledge and understanding of the military lifestyle and culture while maintaining the highest degree of sensitivity, compassion and respect for Service Members and their families. Qualifications: Must be a U.S. Citizen Master's degree or PhD from an accredited graduate program in a mental health related field such as social work, psychology, marriage/family therapy, or counseling Current, valid, unrestricted counseling license in Georgia that grants the authority to provide counseling services as an independent practitioner in their respective fields. Multi-state licensure highly preferred. Ability to meet the expectation to sit / apply for cross-licensure in additional state(s). Licensure costs will be fully covered by the company upon hire Minimum 4 years post masters clinical experience as a mental health and/or substance use clinician with demonstrated understanding of multiple therapeutic modalities, including brief therapy. Knowledge and experience with Employee Assistance Programs (CEAP certification optional) Knowledge and experience in crisis management Solid understanding of Z-codes Proficient with multiple software and system applications. Demonstrated ability to set priorities including, but not limited to time management and organizational skills Ability to manage own caseload and coordinate all assigned cases Passion for helping the military community Understanding of military life and culture After accepting an offer of employment, obtain and maintain a federal public trust clearance status with the US Government. The information that will be requested during the process can be reviewed on the U.S. General Services Administration website: SF85P QUESTIONNAIRE FOR PUBLIC TRUST POSITIONS. You do not need to complete this form or provide any information until after you have accepted an offer of employment. If you are provided an offer of employment and accept, you will need to provide the requested information on the public trust questionnaire directly to the government through a third-party collection agency. Since public trust clearance is a condition of employment, this means that if you are unable to obtain clearance or if you lose clearance, you will not be eligible to work in this position, and your offer may be rescinded or employment may be terminated. REQUIRED WORK HOURS: Full time job with a minimum of forty hours per week five days a week. Shift days and times may vary due to business need. All staff schedules include rotating shifts, weekends and holiday time. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an annual salary of 65,600 - 109,400 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Our mission is to provide immediate, personalized clinical support-whether it's a moment of crisis, clinical consultation, or a step towards lasting change. Our mission is to be responsive, collaborative, and impactful with each connection. As a Behavioral Licensed Clinician on our 24/7 Clinical Support Team, you will deliver expert, compassionate care across a wide spectrum of behavioral health needs. This team is designed to ensure continuity-each Behavioral Licensed Clinician remains with the customer throughout their journey, becoming a trusted clinical partner. While every team member supports various clinical populations and needs, we value and will leverage subject matter expertise in the development of training, curriculum, and clinical consultation. You'll be called on to bring depth into your areas of specialization while remaining flexible and responsive across all cases. The successful candidate will have demonstrated clinical excellence with mental health, substance use disorders, crisis call work, and case management with a passion to deliver a service experience that exceeds the member's or provider's expectation. The team works in a fast-paced environment, on a queue, taking telephonic calls in the moment, balanced with scheduled calendar appointments. The team operates 24/7/365 in support of the full organization. Duties and Responsibilities Serve as a consistent clinical point of contact for each member from first engagement through every stage of their wellness journey Assess members' immediate risk and clinical needs using evidence-based models and clinical acumen Provide real-time crisis de-escalation, safety planning, and risk management Identify biopsychosocial needs and collaborate with the member to determine solutions and next steps Develop SMART goals that empower members to lead and maintain a healthy lifestyle Assesses readiness to change and implements actions to assist members in moving through stages of change to reach their goals Sheppard members to appropriate clinical care, treatment programs, and community resources Incorporate a variety of modalities to educate members about benefit plans, coverage, and care navigation Leveraging an evidence-based specialized curriculum in a wide range of clinical areas that support our members' unique needs Perform research and provide relevant educational or support resources tailored to the member's situation Partner with internal colleagues to ensure timely follow-up, case collaboration, and seamless care transitions Demonstrate agility in balancing real-time queue work with out-of-queue case management responsibilities Exhibit diplomacy, empathy, and professionalism-even in difficult conversations or with resistant participants Comply with HIPAA and uphold strict confidentiality and compliance standards while demonstrating sound clinical documentation practices Able to manage multiple health records and systems to accurately document customer interactions and progress Communicate effectively and succinctly in both verbal and written format Perform other related duties incidental to the work described herein Qualifications Master's degree or PhD in a mental health field (e.g., Social Work, Counseling, Psychology) or RN with psychiatric specialization. Current independent clinical license (e.g., LCSW, LPC, LMFT, LPCC, PhD, PsyD, PMHNP, or RN with psychiatric focus) Minimum 5 years of post-licensure experience as a behavioral health or substance use clinician Bilingual in Spanish preferred Demonstrated use of evidence-based approaches, including brief therapy, cognitive-behavioral therapy, and motivational interviewing Experience working in or with managed care environments preferred Experience with direct member communication (written and verbal), experience in telephonic counseling/coaching preferred Required to obtain AAS Crisis Specialist Certification within the first year of employment EAP (Employee Assistance Program) experience and CEAP certification preferred but not required Strong clinical acumen, interpersonal communication skills, and comfort working in a dynamic and rapid pace environment Proven administrative abilities, with strong computer and software application skills REQUIRED WORK HOURS: Full-time job with a minimum of forty hours per week. Shift days and times may vary due to business need. All staff schedules include rotating shifts, weekends, and holiday time. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an annual salary of 65,600 - 109,400 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.