Highmark jobs

This job supports the matrixed strategic design and analytical approach to reimbursement. To be successful, the incumbent will work closely with stakeholders across the enterprise in the development and implementation of an integrated roadmap for the introduction and delivery of new and innovative reimbursement models across all of Highmark's markets and lines of business. This will require aligning new models to the health plan's strategic objectives based on a deep understanding of innovation and industry trends in both the commercial and government lines of business. This team will be responsible for supporting development and maintaining models that will drive both the return on investment (ROI) and other decisions on the payer partnership constructs. These new approaches require new operational capabilities, and this team is responsible for identifying those gaps, building requirements to drive the development of new capabilities, and tying them to Highmark's strategic capability roadmap. They will need to work effectively across teams to inform and influence change to drive adoption and ROI realization. Critical partners include Advanced Analytics, Contracting, Market and Provider support teams, Actuary, Finance, Highmark Health Solutions, Health Plan Operations. **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority. + Develop the overall conceptualization, strategy alignment, financial models, and high-level design of new reimbursement models for both government and private payers. Programs will include but not be limited to fee for service, pay-for-value programs, episode payments, prospective bundled payments, gain share and risk share models across all lines of business with the goal of maximizing quality while reducing healthcare costs. Develops and maintains a 3-5 year strategic roadmap outlining current and future reimbursement designs across markets and lines of business with input from key executives across the organization. It will require that this team keeps abreast of new developments in both the public and private reimbursement space, including new innovative models developed by CMS to ensure seamless integration and that the organization is ahead of the curve with regard to our strategy. + Work in a Health Economist approach to build and maintain analytical models that performs evaluation of reimbursement models. Continuously evaluates models and seeks for innovative ways to make improvements based on data and market research. Working closely with Contracting and Provider Relation Leaders and others across the enterprise to develop targeted reimbursement models that support enterprise strategic initiatives that might fall outside of planned value-based reimbursement designs and/or to serve as a focus of innovation. + Develop and maintains strategic provider relationships to understand the current health care delivery state, readiness for change, test value based programming concepts and components, identify key partners, identify and proactively communicate market transformation concepts with provider and professional advocacy societies and key thought leaders. Serve as a subject matter expert working in concert with provider relations and clinical transformation consultants to explain new programs and results to key provider partners. + Other duties as assigned or requested. **EDUCATION** **Required** + Bachelor's Degree in Business, Finance, Healthcare Administration, or Related Field **Substitutions** + 6 years of relevant work experience **Preferred** + Master's Degree in Business or Healthcare Administration **EXPERIENCE** **Minimum** + 7 years Healthcare, Healthcare Insurance, Consulting or related area + 3 years Value-based reimbursement, through managed care contracting, provider reimbursement, consulting, population health delivery or related areas + 4 years Research and strategic planning around emerging trends in reimbursement, network, and payment model design. Demonstrate of the application of healthcare economic drivers and/or population health based analytics To include + 1 year Experience working with technology vendors, and other service provider solutions to source key capabilities + 2 years Proven experience in working in a Health Economist capacity driving understanding of current health trends. **Preferred** + 5 years Familiarity with alternative care model designs (e.g., patient centered medical home, ACO), alternative reimbursement models (e.g., bundled payments), and provider / health plan quality programs (e.g. pay for performance) + 5 years Familiarity with the delivery of health care services across the continuum and quality metrics. + 5 years Experience in running large cross organizational programs and projects + 5 years Familiarity with health plan and provider contracting or revenue management + 2 years Understanding of provider contract documents and overall contract management process **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + None **SKILLS** + Excellent written and oral communication skills with the ability to present complex information clearly and persuasively. Including excellent leadership skills, with the ability to relate to all levels of management and staff as well as individuals external to the corporation + Highly effective oral and written communications skills + Ability to manage multiple, complex projects within prescribed timelines + Proficient in MS Office suite, including Word, Excel, PowerPoint and project management software + High level of autonomy and self-direction, to guide reimbursement model design from concept through to execution + Ability to successfully navigate complex organization, engaging multiple stakeholders to achieve reimbursement objectives + Strong financial background and analytical skills with a deep understanding of the economic drivers of healthcare + Comfort and with real-time calculations of cost, membership, etc. (i.e., "back of the envelope" estimations) **Language: (Other than English)** + None **Travel Requirement:** + 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Frequently Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Does Not Apply Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies_ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $126,400.00 **Pay Range Maximum:** $236,000.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J267196

Become a part of our caring community and help us put health first The Senior Program Delivery Professional strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics. The Senior Program Delivery Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Program Delivery Professional - IHWA Interoperability plays a key role in driving seamless data integration and collaboration within the In-Home Health and Wellbeing Assessment (IHWA) team and across interoperability initiatives. Serving as a business subject matter expert (SME), this individual partners closely with internal and external stakeholders, as well as the Interoperability team, to advance program objectives. Key responsibilities include collaborating with leaders on implementation planning, reviewing and communicating program results, and contributing to the ongoing improvement of processes and automation. The role also begins to influence departmental strategy and requires independent decision-making on moderately complex to complex technical matters related to project components. Work is performed without direct supervision, with considerable latitude in determining objectives and approaches to assignments. The ideal candidate demonstrates a collaborative approach, a strong interest in technology solutions, and a commitment to continuous process improvement. Use your skills to make an impact Required Qualifications Minimum three, (3) years of IT project management or business process automation, experience in technology solutions. Excellent communication skills, both oral and written Proven experience in interoperability or data integration within a healthcare or technology setting. Strong problem-solving skills with demonstrated success in process improvement initiatives and process automation. Familiarity with various technology solutions and interest in exploring new innovations. Excellent collaboration, and stakeholder management abilities. Experience with managing and monitoring successful and impactful projects. Self-starter with the ability to work independently and as part of a team. Futuristic and broad thinker with attention to detail and downstream impacts. Preferred Qualifications Bachelor's degree in Information Technology, Computer Science, Information Systems, or a related field. Experience with EHR integration or usage. Experience with AI integration. Experience automating business processes. PMP certification a plus Knowledge and experience in health care environment/managed care Strong analytical skills Workstyle: Open for Hybrid or Remote Work at Home Location: U.S. Schedule: 8:00 AM - 5:00 PM Eastern Time Monday through Friday Travel: occasional onsite as business needs require. Work at Home Guidance 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. SSN Alert 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. Interview Format 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. 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. $86,300 - $118,700 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: 01-08-2026 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.

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. Optum's EHR Services represents one of the fastest growing practices within Optum Insight's Advisory and Implementations business unit. The EHR Services practice is comprised of 600+ individuals across the U.S. and Ireland who are dedicated to improving the healthcare delivery system through the power of healthcare technology, specifically, the EHR and integrated applications and tools. By joining the EHR Services team, you'll partner with some of the most gifted healthcare technology thought leaders within the industry, collaborate with experienced consulting and healthcare leaders, and help partners capture the benefits of their EHR investment. Optum needs a strong Technical Project Manager with hands-on integration (interfaces and conversions) experience to play a crucial role in ensuring the successful execution of EHR Services implementation projects. You will be pivotal in effectively managing integration project teams working in conjunction with other project leaders for large projects, and in owning and running integration specific projects. Your expertise in project management methodologies and hands-on experience with interface and conversion implementations will be vital in coaching, mentoring, and overseeing the completion of tasks. Solid candidates for this role will be able to demonstrate self-motivation, individual leadership, and team collaboration. Most importantly, our EHR Services team will foster a culture of diversity and inclusion and drive innovation for our company and our clients. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. Primary Responsibilities: * Provide subject matter expertise in Epic Healthy Planet, including system design, build, testing, and implementation * Collaborate with leadership and end users to design and configure solutions, providing technical and clinical consultation, including workflow analysis and application configuration to support enhancements and issue resolution * Lead multiple small to medium-scale Epic upgrade initiatives and workflow enhancements through all project phases * Participate in design and validation sessions, ensuring thorough documentation, follow-up, and issue escalation * Maintain system documentation, including design specifications and build records * Monitor production applications and respond to incidents, including participation in 24/7 on-call support as needed * Execute all phases of testing, including unit, system, and integrated testing for EpicCare Ambulatory workflows * Analyze workflows, data collection, reporting needs, and technical issues to support solution development * Collaborate with training teams to develop and maintain application-specific training materials * Translate business requirements into functional specifications; manage system updates, enhancements, and release testing * Ensure compliance with organizational standards for system configuration and change control * Build and maintain strong relationships with end users, stakeholders, and business partners * Facilitate communication across teams from requirements gathering through implementation * Troubleshoot and resolve application issues, escalating complex problems as appropriate * Maintain deep knowledge of Epic functionality and operational workflows 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: * Active Epic certification in Healthy Planet and at least one additional application (i.e., Preferred applications: Ambulatory, Care Everywhere, EpicCare Link or MyChart) * 3+ years of experience in the healthcare industry * 2+ years of direct client-facing experience with healthcare domain knowledge such as clinical documentation workflows, patient portals, encounter closure, and patient flow management * 2+ years of experience with Epic implementation and/or support Preferred Qualifications: * Experience in department build and implementation of Community Connect locations * Experience with Refuel implementations * Proficiency with Excel, Visio, PowerPoint and SharePoint * Proven ability to lead cross-functional teams through clear, effective communication and strategic collaboration Key Competencies: * Time Management & Prioritization. Demonstrates exceptional time management, organizational, and prioritization skills, with a proven ability to manage multiple concurrent responsibilities in fast-paced, dynamic environments * Epic EMR Expertise. Possesses in-depth knowledge of Epic systems, including comprehensive experience across the full implementation life cycle of Epic's suite of applications * Collaborative Leadership. Exhibits a consultative and collaborative leadership style, with a strong track record of aligning cross-functional teams and driving results through shared goals and strategic execution * Relationship Building & Team Motivation. Effectively cultivates and maintains strong internal relationships, inspiring and motivating team members through consultative engagement and influential communication * Strategic Influence & Cross-Functional Collaboration. Demonstrates the ability to build strategic partnerships and influence stakeholders across organizational boundaries. Collaborates across teams, departments, and business units to drive solution standardization, promote reusability, and address complex business challenges * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. Primary Responsibilities: Join a 30+ radiologist group that is based at our Main Campus location with a possible rotation to an outlying satellite clinic. We are seeking a board-certified radiologist interested in general radiology to include: * Radiography * General fluoroscopy and procedures * Proficiency with interpretation of ultrasound and general body CT preferred 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: * Graduate of an approved radiology residency program in the United States * Licensed in the State of Texas * Board Certified and/or Board Eligible * MVR is marked Yes and therefore, driving was listed as a requirement, a corresponding PSQ has been added. Please let us know if this should be changed Preferred Qualification: * Bilingual (English/Spanish) fluency Compensation for this specialty generally ranges from $459,000 to $739,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. 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.

Company :Highmark Inc. : This job is a senior level actuarial analyst position. Participates in Highmark's Actuarial Executive Development Program and is expected to make continued progress towards actuarial credential. Utilizes experience and industry knowledge to define & diagnose a problem, outline data requirements for a study or analysis, and devise potential solutions. Guides and mentors less experienced staff and provides decision support to team members while initiating and leading the development of actuarial studies, analyses, and presentation materials needed to appropriately inform decision makers and making appropriate recommendations to management. Will work to develop efficient processes and will apply actuarial techniques and statistical analysis to several functions which may include insurance premium and pricing development, claim trend analysis, experience studies, medical economics, profitability analysis, wellness studies, predictive modeling, provider efficiency, provider contracting analysis or claim reserving. ESSENTIAL RESPONSIBILITIES Define & diagnose a problem. Outline data requirements for a study or analysis and devise potential solutions. Review the appropriateness of the results in light of experience and industry knowledge. Consider alternate explanations or viewpoints before drawing conclusions. Create studies, analyses, and presentation materials needed to appropriately inform decision makers. Make appropriate recommendations to management across teams within the actuarial department. Proactively ensure the internal and external consistency of all work. Use industry knowledge to perform reasonability checks as well as exceed customer expectations. Identify methods to test whether suspect results are correct. Take the initiative to utilize internal and external knowledge forums to gain broader industry perspective. Demonstrate subject matter expertise, and as a result is sought out by others for technical input on producing accurate and efficient work. Promptly and efficiently identify outliers and anomalies in the work of others. Seek continual feedback from manager and others in order to advance personal development and career goals. Understand the environment, goals, and objectives of the incumbent's own position, their team, and all internal customers. Use experience and industry knowledge to envision and implement new processes and propose changes to existing processes, leading to improved outcomes that better conform to corporate goals, objectives, and values. Demonstrate a capacity to shift between “big picture” and “detailed” thinking when analyzing issues and their strategic importance. Independently manage own time and resources across many projects. Demonstrate responsiveness, flexibility, and ability to independently prioritize when shifting from one task to another. Comfortable in a dynamic, changing environment. Approach new challenges with anticipation and a view towards success. Carry out recurring projects with minimal assistance and oversight. Keep manager informed. Interact with stakeholders in a manner that fosters cooperation and teamwork while conveying engagement and competence. Enhance department influence by providing responsive service and understanding customer needs. Effectively explain technical work to both technical and non-technical people and provide decision support to team members. Correctly interpret direct and indirect messages and verbal and non-verbal behaviors and respond appropriately. Guide and mentor less experienced staff on a regular basis in a manner that fosters teamwork and excellence. Listen, take direction, accept criticism and feedback and adjust behavior accordingly to improve performance. Demonstrate flexibility and proactively take on additional work as needed by the team, leading by example. Other duties as assigned or requested. EDUCATION Required Bachelor's Degree or its equivalent in Actuarial Science, Mathematics, Statistics or closely related discipline Substitution None Preferred Master's Degree or its equivalent in Actuarial Science, Mathematics, Statistics or closely related discipline EXPERIENCE Required 3 years experience in an Actuarial role 6 Exam Components Preferred 10 or more Exam Components LICENSES AND CERTIFICATIONS Required None Preferred None SKILLS Possesses and applies an in-depth knowledge of actuarial principles, concepts, practices and processes within multiple fields or disciplines Possesses significant expertise to complete complex assignments and ability to visualize, articulate, and solve complex problems while leading others to complete straightforward assignments Analytical Skills Oral & Written Communication Skills Problem-Solving Language (Other than English): None Travel Requirement: 0% - 25% PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS Position Type Office-based Teaches / trains others regularly Frequently Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Frequently Audible Speech Constantly Hear Constantly Position self or move lower on ground, under tables/desks, etc. Never Climb Never Drive Occasionally Reach Frequently Sedentary position Frequently Move Frequently Repetitive Motion Frequently Use Hands/Fingers to Handle or Feel (beyond just data entry) Frequently Vision - Distinguish Color Frequently Vision - Far, Near, Depth Perception Frequently Move, transport, transfer - up to 10 lbs (Sedentary Work) Occasionally Move, transport, transfer - up to 20 lbs (Light Work) Occasionally Move, transport, transfer - up to 50 lbs (Medium Work) Occasionally Move, transport, transfer - excess of 50lbs (Heavy Work) Never Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. Pay Range Minimum: $67,500.00 Pay Range Maximum: $126,000.00 Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice

HNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we serve. Responsible for definition, planning and delivery of complex programs that require cross-functional collaboration and management of interdependencies between a group of projects and/or related activities within the constraint of scope, quality, time and budget. Includes the management of a group of internal exempt and/or matrixed employees and contractors that serve on the program(s) to deliver solutions for the business. **ESSENTIAL RESPONSIBILITIES:** + Works with business and technical organizations to drive out program strategy and approach. Organizes, plans, and maintains Program roadmap consisting of cross-functional activities/projects. + Work with business and technical organizations to assemble project teams. Lead Project Managers and Program team in the development and maintenance of comprehensive plans for a defined program. + Work with Executive Sponsor and Business Owner of a Program, and other management as required, to achieve the Program objectives. Acquire understanding of the business objectives for an assigned area." + Monitor, evaluate and report on Program status inclusive of scope, schedule, budget and alignment to Program and strategic goals. Direct corrective action as needed to maintain the viability of the Program. + Develop and maintain positive customer relationships. Deliver presentations of project status to effectively communicate throughout the project lifecycle. + Adhere to Highmark project management methods, project lifecycle methodologies, and audit requirements. Support and contribute to the improvement of project management methods and practices. + Other duties as assigned or requested. **QUALIFICATIONS:** Minimum + High School Diploma or equivalent + One (1) to three (3) years experience performing project coordination activities such as analysis, information gathering, documentation preparation, project schedule maintenance, status report preparation, budget tracking, etc. Preferred + Bachelor's degree + PMP certification or equivalent training + Health Care Insurance industry business and operational knowledge + Leadership skills + Solid organizational and planning skills + Exposure to an industry standard software development lifecycle + Good verbal and written communication skills + Good interpersonal skills **Knowledge, Skills and Abilities** + Experience with customer relationship management + Presentation skills + Negotiation skills + Experience with conflict resolution + Experience with Risk Mitigation Planning **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $50,200.00 **Pay Range Maximum:** $91,200.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J271523

This job serves as the single-point-of-contact for sales teams and assigned customers, delivering insights and recommendations to sales in order to aid customer acquisition/retention while maintaining performance goals. This incumbent will collaborate with cross functional team members on client-level quotes and function as a trusted adviser by providing financial and risk management support to sales as well as strategic insight. **ESSENTIAL RESPONSIBILITIES** + Understand department and the company'sstrategic goals and competitive position and drives client-level results towards these ends. Actively work with Sales team to manage portfolio of clients towards financial and business targets, e.g. membership, revenue, margin, etc. + Proactively draw insights from quote details, client understanding and regional insights to deliver best-possible recommendation to Sales. State and maintain independent perspective, including under pressure from more senior individuals, identifying opportunities and concerns. + Responsible for portfolio of clients through underwriting engagement, from identification through documentation of final sold-contract details + Assess risk by looking at various risk measures such as risk scores, demographic analysis, and turnover considerations. + Serve as the accountable owner for all quotes delivered to sales partners. Develop a perspective on each client package deliverable. Clearly and confidently communicates Underwriting's position on the risk profile of each client + Identify tool improvement needs and communicates needs to Product Development teams + Maintain accurate book management details including concession budget + Other duties as assigned or requested. **Required** + Bachelor's Degree in Science, Technology, Mathematics or related field **Substitutions** + Six (6) years additional experience required in lieu of degree **Preferred** + None **EXPERIENCE** **Required** + 3 years of Health Care Underwriting OR risk mgmt OR actuary work OR applying advanced mathematics to include + 1 years of external client interaction or comparable external interactions **Preferred** + 1 year in Risk Management **OR** of Actuary work **OR** of applying Advanced Mathematics **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + None **SKILLS** + Understanding of health products, services, risk assessment and techniques + Consultative mindset + Strong Oral and Written Communications skills **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Rarely Travel regularly from the office to various work sites or from site-to-site Occasionally Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Rarely Lifting: 25 to 50 pounds Never **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $50,200.00 **Pay Range Maximum:** $91,200.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J272541

**Optum NV is seeking a Medical Oncology Resident Pathway to join our team in Las Vegas, NV. Optum is a clinician-led care organization that is changing the way clinicians work and live.** **As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.** At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you'll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while **Caring. Connecting. Growing together.** You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Position Highlights:** + **_This is a temporary role intended for physician residents in their final year of training, interested in pursuing a full-time role with our group following completion of residency_** + **_OptumCare will educate and prepare physicians to join our group full time, providing a customized program with exposure to our radiation oncology team as well as Optum as an organization. The commitment requires only a few hours per month maximum_** **_Compensation & Benefits Highlights:_** + **_Physician Resident will receive an adjusted annual salary_** OptumCare Nevada, is Nevada's largest multi-specialty practice, with over 350 physicians and advanced practice clinicians. Our facilities include 22 medical offices, with 13 urgent cares and retail clinics, two lifestyle centers catering to seniors and two outpatient surgery centers. The practice is fully integrated and includes home health, complex disease management, pharmacy services, medical management and palliative care. OptumCare Nevada is actively engaged in population health management, with an emphasis on outcomes, and offers patients compassionate, innovative and high-quality care throughout Nevada. OptumCare Nevada is headquartered in Las Vegas, Nevada. OptumCare Cancer Care is seeking a Radiation Oncology Physician for our Radiation Oncology division located in Las Vegas, NV. This is an outstanding opportunity for a physician 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:** + **_M.D. or D.O_** + **_Transitioning into final year or early into final year of residency/fellowship_** + **_Board Certified/Board Eligible in specialty_** + **_Active unrestricted NV license and DEA or ability to obtain prior to employment_** *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy **California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington** **or** **Washington, D.C. Residents Only:** The salary range for this role is $33,280 to $41,700 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _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._

*****CANDIDATE MUST BE US Citizen (due to contractual/access requirements)***** This job is an integral member of one of our teams responsible for supporting the design, development, and maintenance of our technical solutions, ensuring their efficient and reliable operation. This position will be responsible for contributing to our technical ecosystem including infrastructure, systems, networks, applications, integrations, **and providing critical support for API solutions.** They will work closely with other technical professionals, analysts, and engineers to build and optimize solutions, ensuring quality, integrity, and performance. The ideal candidate is adaptable, solution-oriented, and capable of collaborating across multiple teams to support a broad range of technical initiatives. The incumbent, and team, may be involved in every aspect as a part of the technical process from idea generation, analysis, design, build, and support using various technologies and design patterns. **ESSENTIAL RESPONSIBILITIES** + Responsible for one or many of the following tasks: analyzing, designing, coding, testing andimplementingtechnical solutions, as well as providing general production monitoring and support, meeting defined scope, target dates and budgets with minimal or no defects. + Collaborate with stakeholders across IT, product, analytics, and business teams to gather requirements and provide technical solutions that meet organizational needs + Monitor work against production schedule andprovide progress updates and report any issues or technical difficulties to leadership on a regular basis. + Document technical processes and procedures, and participate in technical reviews and knowledge sharing sessions + Collaborate on the design and implementation of with architecture to ensure solution alignment to enterprise goals and standards + Perform technical analysis and provide insights to support decision-making across various departments + Stay up-to-date with the latest relevant technologies and industry best practices + Other duties as assigned or requested. **EXPERIENCE** **Required** + 3 years of experience in one or many of the following tasks: analyzing, designing, coding, testing and implementing technical solutions, as well as providing general production support, meeting defined scope, target dates and budgets with minimal or no defects + 3 years of technical problem solving, solution implementation, team/project collaboration experience + 3 years of basic computer science concepts and principles, common operating systems, development languages/scripting **Preferred** + Understanding and experience with API technologies Axway API gateway, Amplify API management, Elasticsearch Logstash and Kibana(ELK) + 5 years of experience with technology platforms, application development tools, business processes, software development life cycle used by our enterprise + 5 years of experience defining system architectures and exploring technical feasibility trade-offs for optimizing short term execution while planning for long term technical capabilities + 5 years of experience working with a variety of technology systems, designing solutions or developing technology solutions in healthcare + 5 years of technical governance, quality, and technical security best practices + 5 years of experience translating requirements, design mockups, prototypes or user stories into technical designs + 5 years of producing technical solutions that are fault-tolerant, efficient, and maintainable **SKILLS** + Demonstrated ability to achieve stretch goals in a highly innovative and fast-paced environment + Adaptability: Ability to take on diverse tasks and projects, adapting to the evolving needs of the organization + Analytical Thinking: Analytical skills with a focus on detail and accuracy + Interest and ability to learn other technologies as needed + Technical Proficiency: Comfortable with a range of data tools and technologies, with a willingness to learn new skills as needed + Track record in designing, implementing, and/or supporting large-scale technical solutions + Sense of ownership, urgency, and drive + Demonstrated passion for user experience and improving usability + Team Collaboration: A team player who can work effectively in cross-functional environments **EDUCATION** **Required** + Bachelor's degree in Computer Science, Information Systems, Computer Engineering or relevant experience and/or education as determined by the company in lieu of bachelor's degree. **Preferred** + Master's degree in Computer Science, Information Systems,Computer Engineering or related field. **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + None **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office- or Remote-based Teaches / trains others Occasionally Travel from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required No Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $67,500.00 **Pay Range Maximum:** $126,000.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273124

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. This Director level is accountable for achieving assigned targets for Medicare Advantage providers in their assigned Market(s). The Director is responsible for developing and deploying business plans at the market level with a solid focus on managing CMS Risk Adjustment, Clinical Quality, HEDIS and Stars initiatives and building relationships across Market(s) to develop and optimize business opportunities and brand strength. Serving as the local Market expert, work with central function leads to target local strategies that will result in optimal Market(s) effectiveness. You'll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. Primary Responsibilities: * Ensure targets are met or exceeded for assigned Market(s) * Development and execution of clinical, RAF and quality strategy related HEDIS and Part D Stars Improvements in partnership with Medicare Market CEO, Executive Director, Data Support, and other Optum and UHC parties as appropriate * Regular reporting and updates to senior leadership, including Health Plan CEO, CMO, and market leads, this requires development of PowerPoint and Excel data packages * Leadership and support of achieving a minimum of 4 Star rating for assigned H contracts and for achieving 80% of our members in 4 Star or better plans * Solid focus on employee development and employee experience * Monitor Market level trends, risk and opportunities to continually evaluate ability to achieve established targets * Create provider targets for direct reports and assist in territory management penetration * Actively participate in the development and execution of site Coding Accuracy, HEDIS, (prospective and retrospective), Patient Experience and Stars strategic/business plans * Influence the development and improvement of operations/service processes * Drive the development and implementation of short-and-long range plans * Continually assess market competitiveness, opportunities, and risks * Drive initiatives to optimize Medicare Advantage payment and reimbursement strategy and capabilities * Build and maintain collaborative relationships with Corporate, Business units within UHG and other Medicare Advantage Plans, Provider relations/Network Development, Marketing and Sales, Clinical Operations, Senior Director leadership in each market * The Director will be accountable to ensure direct reports that oversee the field staff are performing at a high standard of performance * Be the primary go to person for all Risk/STARS related activities within their assigned market(s) working within a matrix relationship which includes Network, Market Leads, Health Plan Medical Directors, and other Health Plan and Optum team members to assure that all STARS activities are planned and executed * Weekly commitment of 50% travel for business meetings (including client/health plan partners and provider meetings) and 50% remote work You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * 5+ years of experience in a high impact role as a leader in the managed health care industry * 5+ years of Medicare Stars experience and HEDIS experience * Experience in the development and execution of Coding Accuracy, HEDIS (prospective and retrospective), Patient Experience and Stars strategic/business plans * Experience developing and improving operations / service processes including short and long range plans * Demonstrated experience on driving initiatives to optimize Medicare Advantage payment and reimbursement strategy and capabilities * A broad base of experience across management care operations, extensive knowledge of health care industry, provider and insurance industry is required to be successful in this role * Weekly commitment of 50% travel for business meetings (including client/health plan partners and provider meetings) and 50% remote work Preferred Qualifications: * Reside in the upper Midwest (Missouri / Nebraska / Iowa / Illinois ) * 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 $110,200 to $188,800 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.

Explore opportunities with Christus Homecare, 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 Scheduling Specialist you will managing patient referrals and visit schedules. Assigns patient assessments and other visits as ordered by the physician using an online scheduling system. Collaborate with the Team Leader to identify clinicians with the appropriate experience and skill set to match patient needs. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Utilizes an automated scheduling system to maintain a calendar of services for both episodic and per visit customers * Processes workflow for requested scheduled, missed, rescheduled, reassigned, declined, and delivered visits * Monitors pending referrals daily and assigns licensed professional and case manager for all start of care visits * Communicates daily with field staff regarding any visits unaddressed in late, pending, or incomplete status for resolution as appropriate 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: * High school education or equivalent experience Preferred Qualifications: * 1+ years of scheduling experience in a health care setting using an online scheduling system * Exceptional organizational, customer service, communication, and decision-making skills * Working knowledge of state and federal regulations governing OASIS visits, supervisory, and reassessment visits * 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 $14.00 to $27.69 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 DBA is responsible for the overall database delivery of the Enterprise Data Warehouse for the Medicaid agency. It is a critical role involving expertise in working with Medicaid data itself, security, supporting and maintaining hardware and software, and ensuring we are achieving optimal performance. For example, the DBA is expected to provide a wide range of expertise including the ability to help a user to fetch data (requiring business knowledge) and the technical ability to support a major Teradata upgrade. This role requires regular onsite presence in Springfield, Illinois to perform backup/restore and support onsite maintenance by Teradata (and its subcontractors). This position will be part of our Data Engineering function and data warehousing and analytics practice. Data Engineering Functions may include database architecture, engineering, design, optimization, security, and administration; as well as data modeling, big data development, Extract, Transform, and Load (ETL) development, storage engineering, data warehousing, data provisioning and other similar roles. Responsibilities may include Platform-as-a-Service and Cloud solution with a focus on data stores and associated eco systems. Duties may include management of design services, providing sizing and configuration assistance, ensuring strict data quality, and performing needs assessments. Analyzes current business practices, processes and procedures as well as identifying future business opportunities for leveraging data storage and retrieval system capabilities. Manage relationships with software and hardware vendors to understand the potential architectural impact of different vendor strategies and data acquisition. May design schemas, write SQL or other data markup scripting, and helps to support development of Analytics and Applications that build on top of data. Selects, develops, and evaluates personnel to ensure the efficient operation of the function. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Manage, monitor, and maintain OnPrem Teradata hardware/software including patches, replacements, and upgrades with support from Teradata + Support data governance, metadata management, and system administration + Plan and execute tasks required to ensure the Teradata system is operational including occasional evening and weekend support for Teradata maintenance + Provide direction to developers on Operational, Design, Development, and Implementation projects to ensure best use of the Teradata system including review/approval of database components (such as tables, views, SQL code, stored procedures) + Performing database backup and recovery operations - using the BAR DSA and NetBackup + Developing proactive processes for monitoring capacity and performance tuning + Providing day-to-day support for the EDW users problems like job hands, slowdowns, inconsistent rows, re-validating headers for tables with RI constraints, PPIs, and configuration + Maintaining rules set in the Teradata Active System Management (TASM) and supporting workload management + Maintaining the Teradata Workload Manager with the proper partitions and workloads based on Service Levels + Supporting the database system and application server support for the Disaster Recovery (DR) build/test, annual drill, and quarterly maintenance as needed + Actively monitoring the health of the Teradata system and Teradata Managed Servers (TMS) using Viewpoint and other tools and application servers and make preventive or corrective actions as needed + Maintaining access rights, role rights, priority scheduling, and reporting using dynamic workload manager, Database Query Log (DBQL), usage collections and reporting of ResUsage, AmpUsage, and security administration etc. + Coordinating with the team and customers in supporting database needs and making necessary changes to meet the business, contractual, security, performance, and reporting needs + Supporting internal or external audit process and address vulnerabilities or risk proactively + Prepare and support IRS and internal audit + Coordinating with Teradata to perform Teradata system hardening and delivery of Safeguard Computer Security + Evaluation Matrix (SCSEM) Reports as needed, addressing issues in the hardening and vulnerability scan report + Generating and maintaining capacity management, Space, and CPU reports on analyzing the Spool, CPU, I/O, Usage, and Storage resources and proactive monitoring to meet performance and growth requirements + Reviewing and resolving Teradata alerts and communicating any risk / issues or impact to the management, team, and business users through appropriate communication strategy + Effectively reporting status, future roadmap, proactive process improvements, automation, mitigation strategies, and compensating controls to the management and clients + Leading database or data related meetings and projects/activities delivering quality deliverables with minimal supervision/direction + Sharing knowledge, coaching/mentoring other members in the team for backups + Performing additional duties that are normally associated with this position, as assigned + Responsible for front-end tool (OpenText Bi-Query) and model maintenance and administration 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:** + 7+ years of experience as a Teradata DBA on Version 15+ (preferably 17+) and experience leading Teradata major upgrade/floor sweep + 5+ years of experience as primary/lead DBA with solid leadership and presentation skills + 5+ years of experience writing complex SQL using SQL Assistant/Teradata Studio + 3+ years of experience with Teradata 6800/1800 system or IntelliFlex + 3+ years of experience extracting, loading, and transforming structured/unstructured data using Teradata Utilities (FastLoad, Multiload, FastExport, BTEQ, TPT) in a Unix/Linux environment + 3+ years of experience performance tuning in a large database (>5TB) or data warehouse environment, using advanced SQL, DBQL and Explain plans + 3+ years of experience analyzing project requirements and developing detailed database specifications, tasks, dependencies, and estimates + 3+ years of experience identifying and initiating resolutions to customer facing problems and concerns associated with a query or database related business need + Data warehouse or equivalent system experience + Demonstrated excellent verbal/written communication, end client facing, team collaboration, mentoring skills, and solid work ethics + Demonstrated solid culture fit through integrity, compassion, inclusion, relationships, innovation, and performance **Preferred Qualifications:** + Teradata Vantage Certified Master + 5+ years logical and physical data modeling experience + 5+ years with Erwin or other data modeling software + 3+ years maintaining and creating models using OpenText BI-Query + 3+ years identifying and initiating resolutions to customer problems and concerns associated with a Data Warehouse or equivalent system + 3+ years working with end users/customers to understand requirements for technical solutions to meet business needs + 3+ years collaborating with technical developers to strategize solutions to align with business requirements + 3+ years defining standards and best practices and conducting code reviews + Experience working with project teams in metadata management, data/IT governance, business continuity plan, data security + Experience in Application Server Hardware/Software Administration (Windows/Linux) + Experience working in matrix organization as an effective team player + Experience working in agile environment such as Scrum framework and iterative/incremental delivery/release. + Experience in tools like DevOps and GitHub + Experience with State Medicaid / Medicare / Healthcare applications + Experience working in large Design Development and Implementation (DDI) projects + Experience upgrading to Teradata IntelliFlex + Knowledge/experience with Cloud databases such as Snowflake and migration from on Prem to Cloud project *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 $110,200 to $188,800 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._

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Location: Position is hybrid. Candidate must live in TX. Prefer candidate to live in/around Austin, San Antonio, or Dallas. Position Purpose: Establishes and fosters a healthy working relationship between large physician practices, IPAs and Centene. Educates providers and supports provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for HEDIS measures, appropriate medical record documentation and appropriate coding. Assists in resolving deficiencies impacting plan compliance to meet State and Federal standards for HEDIS and documentation standards. Acts as a resource for the health plan peers on HEDIS measures, appropriate medical record documentation and appropriate coding. Supports the development and implementation of quality improvement interventions and audits in relation to plan providers. Delivers, advises and educates provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with state, federal, and NCQA requirements. Collects, summarizes, trends, and delivers provider quality and risk adjustment performance data to identify and strategize/coach on opportunities for provider improvement and gap closure. Collaborates with Provider Relations and other provider facing teams to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters). Identifies specific practice needs where Centene can provide support. Develops, enhances and maintains provider clinical relationship across product lines. Maintains Quality KPI and maintains good standing with HEDIS Abstraction accuracy rates as per corporate standards. Ability to travel up to 75% of time to provider offices. Performs other duties as assigned. Complies with all policies and standards. Education/Experience: Bachelor's Degree or equivalent required 3+ years in HEDIS record collection and risk adjustment (coding) required Licenses/Certifications: One of the following required: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS For Superior HealthPlan: license/certification is preferred Location: Position is hybrid. Candidate must live in TX. Prefer candidate to live in/around Austin, San Antonio, or Dallas. Pay Range: $26.50 - $47.59 per hour 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

Company :Allegheny Health Network : Performs all functions related to polysomnographic exams and multiple sleep latency testing to provide comprehensive diagnostic evaluation and treatment of sleep disorders. Functions under licensed medical direction. ESSENTIAL RESPONSIBILITIES: Performs all polysomnograms and MSLTs according to clinical practice guidelines, as well as departmental policy and procedures. May score test results. (70%) Maintains proper calibration, quality control and analysis of all polysomnographic equipment. (10%) Organizes and prioritizes workload and scheduling of patient testing in an efficient and effective manner. (10%) Assists with billing documentation and maintains department records according to departmental policy/procedure. (10%) Performs other duties as assigned or required. QUALIFICATIONS: Minimum CPR - American Heart Association. Act 34 Criminal Background Clearance Certificate. Act 33 Child Abuse Clearance Certificate. Act 73 FBI Fingerprinting Criminal Background Clearance Certificate Preferred Associate's Degree in Respiratory Therapy. Graduate of polysomnography course or completion of an approved sleep lab training program. Basic EEG course. RPSGT, CRT, RRT or LPN. Sleep study testing experience. Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice

**Internships at UnitedHealth Group.** If you want an intern experience that will dramatically shape your career, consider a company that's dramatically shaping our entire health care system. UnitedHealth Group internship opportunities will provide a hands-on view of a rapidly evolving, incredibly challenging marketplace of ideas, products and services. You'll work side by side with some of the smartest people in the business on assignments that matter. So here we are. You have a lot to learn. We have a lot to do. It's the perfect storm. Join us to start **Caring. Connecting. Growing together.** You'll be at the intersection of sales and healthcare, about to create the next incredible solution for insurance customers primarily under the age of 65. If you want to advance your learning in a technology environment that's always pushing the envelope, you've come to the right place. The UnitedHealthOne team, part of UnitedHealthcare's thriving family of businesses, is a team of people who are passionate about using consultative sales to help improve the lives of millions and make health care work better for all. Throughout your 6-month Co-op Early Careers internship experience, you'll be licensed and credentialed as an Insurance Professional. You'll be trained on the tools and products, as well as the sales and compliance techniques to serve as a trusted agent for potential customers. In addition, the Co-op also offers networking, collaboration opportunities as well as mentorship from experienced insurance professionals and leaders. The intent of our Co-op program is to provide return internship opportunities or full-time employment opportunities at UnitedHealthOne, depending on eligibility. This Co-op position will be available for the Summer/Fall semester, TBD (unlicensed). If already licensed with an active Life and Health Insurance License when hired The internship will take place from Summer 2026 - mid December 2026. **Hours of the role:** + First 8 weeks 40 hours per week (orientation. Pre-licensing prep, and training will be Monday - Friday 8:00am - 4:45pm ET + Ability to work 40 hours per week during full hours of operation, 8am - 10:45pm ET, based upon business need (orientation, pre-licensing preparation, and training is typically 8:00am - 4:45pm ET for approximately the first 8 weeks; evening & weekends may be required post-training, with notice given on change of hours) **Commitment Expectations:** + Generally, this means that students have limited, additional coursework (0 - 6 credit hours for the fall semester), along with outside commitments that are flexible to the agreed-upon work hours for the duration of the Co-op + This is not a situation where hours and location of work are at the discretion of the student; hours are agreed upon, in advance, with the Co-op supervisor, and work location needs to be a protected health information (PHI) compliant space (no coffee shops or generally other 'open' Wi-Fi networks are to be used) You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on this fulfilling opportunity. **Primary Responsibilities:** + Successfully become licensed in health & life within your resident state** within the first 30 days of Co-op, if not already licensed + Successfully pass FFM (Federally Facilitated Marketplace) and other potential state based exchanged certifications within first 90 days of Co-op + Handle leads from both a dedicated carrier leadsource (UHC) and a multi-carrier leadsource (HealthMarkets) + Receive inbound calls from leadsources and offer available ACA (Affordable Care Act) products based on an established sales process that includes required scripting and highly compliant, needs-based selling + Conduct follow-up calls to consumers who have not yet purchased the product(s) discussed on a previous call, which may include calls made by other licensed agents, to help close the sale + Handle chats with prospective customers according to training and guidelines for the lines of business identified 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:** + Currently pursuing a Bachelor's degree from an accredited college/university + Actively enrolled in an accredited college/university during the duration of the Co-op. Not intended for graduating seniors + Must be eligible to work in the U.S. without company sponsorship, now or in the future, for employment-based work authorization. F-1 visa holders with Curricular Practical Training (CPT) or Optional Practical Training (OPT) who will require visa sponsorship, TN visa holders, current H-1B visa holders, and/or those requiring green card sponsorship will not be considered **Preferred Qualifications:** + Pursuing a degree in Sales, Business, Communication, Healthcare, or Insurance + Intermediate Microsoft Office skills (Outlook, Word, Excel, Powerpoint) + Eagerness to learn about the healthcare system & insurance + Solid communication skills (both written and verbal) + Good problem-solving skills with attention to detail + Ability to work independently with minimal supervision in a fast-paced team environment 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 $18.00 to $32.00 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.** This position is a Medicaid Subject Matter (SME) Expert for the Enterprise Data Warehouse supporting the State Medicaid program. This role requires significant expertise of Medicaid Enterprise System modules and data warehousing or decision support systems. This role provides the guidance and direction to support a large data warehouse implementation and maintenance & operations. The selected SME will provide the required decisions for the business and technical team members to modify, change, enhance or correct within the system, related to claims, provider, and recipient data. Roles in this function will partner with stakeholders to understand data requirements and support development tools and models such as interfaces, dashboards, data visualizations, decision aids and business case analysis to support the organization. Additional roles include producing and managing the delivery of activity, value analytics and critical deliverables to external stakeholders and clients. This is a telecommute position with some ( You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. **Primary Responsibilities:** + Provide direction, guidance and recommendations supporting decision making for large Medicaid data warehouse implementation and operations + With the specialized knowledge of the Medicaid and Children's Health Insurance Programs (CHIP), lead and guide internal and external stakeholders to make determinations relating to complex processes involving claims processing/adjudication, recipient eligibility, provider enrollment, and third-party liability + Proactively identify and understand state Medicaid agency data needs and determines the recommended solution to meet them with credible reason, justification and validated proof of concepts + Direct technical and business teams on healthcare topics understanding and utilizing healthcare data appropriately + Proactively suggest and recommend enhancements and improvements throughout the project processes, driven by Medicaid best practices, standards and policies 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:** + 10+ years of experience in information technology with 5+ years of experience working directly with/for State Medicaid agencies or equivalent supporting business initiatives through data analysis, writing business requirements and testing/validation of various systems + 2+ years of experience working CMS Federal Reporting MARS, PERM, T-MSIS, Quality of Care CMS Core Measure or similar projects + Knowledge of the Centers for Medicare and Medicaid Services reporting requirements and the programs covered + Understanding of claims, recipient/eligibility, and provider/enrollment data processes + Proven ability to create and perform data analysis using SQL, Excel against data warehouses utilizing large datasets + Proven excellent verbal/written communication and presentation skills, manager/executive/director-level client facing, team collaboration, and mentoring skills + Proven solid culture fit, demonstrating our culture values in action (Integrity, Compassion, Inclusion, Relationships, Innovation, and Performance) + Ability to travel to Springfield, IL two (3) to three (4) times per year or as needed **Note:** Core customer business hours to conduct work is M-F 8 AM - 5 PM CST. **Preferred Qualifications:** + 2+ years of experience in HEDIS, CHIPRA or similar quality metrics + Experience with data analysis using Teradata Database Management System or other equivalent database management system + Experience using JIRA, Rally, DevOps or equivalent + Experience in large implementation or DDI project + Located within driving distance (3 - 5 Hours) of Springfield, IL *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 $110,200 to $188,800 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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start **Caring. Connecting. Growing together.** We're making a solid connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that's driving the health care industry forward. As a Telephone Case Manager RN with UnitedHealth Group, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today! The **Telephonic Case Manager RN Medical/Oncology** will identify, coordinate, and provide appropriate levels of care. The Telephonic Case Manager RN Medical/Oncology is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. **This is a full-time, Monday - Friday, 8am-5pm position in your time zone.** You'll enjoy the flexibility to work remotely* as you take on some tough challenges. **Primary Responsibilities:** + Make outbound calls and receive inbound calls to assess members current health status + Identify gaps or barriers in treatment plans + Provide patient education to assist with self-management + Make referrals to outside sources + Provide a complete continuum of quality care through close communication with members via in-person or on-phone interaction + Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. Solid computer and software navigation skills are critical. You should also be solidly patient-focused and adaptable to changes. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Current, unrestricted RN license in state of residence + Active Compact RN License or ability to obtain upon hire + 3+ years of experience in a hospital, acute care or direct care setting + Proven ability to type and have the ability to navigate a Windows based environment + Have access to high-speed internet (DSL or Cable) + Dedicated work area established that is separated from other living areas and provides information privacy **Preferred Qualifications** + BSN + Certified Case Manager (CCM) + 1+ years of experience within Medical/Oncology + Case management experience + Experience or exposure to discharge planning + Experience in a telephonic role + Background in managed care *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

**SUMMARY OF JOB RESPONSIBILITIES** This job has the goal of providing the opportunity to acquire practical experience through direct exposure to the related business line(s) and to develop the next generation of diverse business professionals. To that end, the program will provide hands-on training and experience in the business line, expose the various career opportunities in the business line and related areas, and prepare participants for positions in the business. **REQUIRED QUALIFICATIONS** Bachelor's degree. Pursuance of a graduate degree full or part-time in an accredited college or university in Software Engineering, Data Analytics, Computer Science or a related area. **ESSENTIAL JOB FUNCTIONS** 1. Communicate effectively. This position displays effective communication skills while interacting directly with colleagues, clientele, and/or other internal or external constituencies in the planning of assignments and the resolution of day-to-day operational problems. 2. Under supervision, provide professional services as appropriate to the day-to-day operating objectives of the area. Receives guidance, training, and mentoring from senior personnel in planning and carrying out activities and assignments. 3. Undertake and/or participate in projects and programs designed to develop professional skills and expertise appropriate to the needs of the organization. 4. Participate in the planning and implementation of unit projects and initiatives within area of expertise and ability. 5. As specifically requested by management, conducts research and reporting inclusive of recommendations or alternative proposals for action. 6. Undertake related studies or enrichment programs as appropriate to the specific objectives of the operating unit. 7. Perform miscellaneous job-related duties as assigned. **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement:_** _This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies_ As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. **Pay Range Minimum:** **Pay Range Maximum:** _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J270859

Explore opportunities with Lafayette Home Office, 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 Revenue Cycle Analyst you will perform all revenue cycle reporting and analysis for revenue cycle leadership, operational teams, and accounting. This analysis consists of daily, weekly, monthly, ad ad-hoc reports using real-time data and information (financial, statistical and other data). The results of the analysis are then used to provide revenue cycle leadership and operations management (DVPs and other operations management) with real-time feedback. As the Revenue Cycle Analyst, you will have no direct report staff and solicits feedback from both Decision Support leadership and VP of Revenue Cycle. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Perform financial and reimbursement analysis to ensure accurate reimbursement and billing compliance + Conduct data mining to compile reports and provide healthcare analytics support for decision-making related to AR inventory reduction, denial management, and operational improvements + Compile and prepare data for use in forecasts, budgets, modeling, and analysis as requested + Compile statistical data for internal reports and regulatory agencies + Assist in creating a data warehouse with needed information (process started; work with IT to complete) + Collaborate with the revenue cycle team to regularly measure and improve business performance + Produce daily, weekly, and monthly revenue cycle reports in a timely, accurate, and consistent manner + Work with revenue cycle leadership to develop key performance indicators and improve reporting + Prepare variance analysis on under-performing agencies/PODs related to days unbilled, production issues, etc., and suggest operating improvements + Maintain excellent communication with supervisor, revenue cycle management personnel, and home office personnel + Actively participate in Monthly Operational Review meetings + Complete ad-hoc analysis projects as required (problem payer work, issue resolution, collection effectiveness measures, etc.). You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Bachelor's Degree + 2+ years in a healthcare-related field + 2+ years in relevant Professional Accounting/Financial Analysis experience + Demonstrate superior analytical skills, both financial and statistical + Demonstrated a natural sense of urgency in all actions + Demonstrated ability to use modern accounting and financial software platforms and databases + Demonstrated solid proficiency in Microsoft Office applications. **Preferred Qualifications:** + Proven solid oral and written communication skills. + Excellent interpersonal skills + Ability to work alongside other management personnel to achieve high levels of operating performance. + Demonstrated ability to influence other personnel to produce improved operating outcomes. + Self-starter and self-motivated, able to consistently demonstrate these qualities in a fast-paced environment. *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 $14.00 to $27.69 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._