Highmark Remote jobs

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

Summary of Job Responsible for overseeing daily operations and administrative functions to ensure efficient pharmacy workflow and a positive patient experience. Provide a combination of operational oversight and customer service resolution. Oversee daily non-clinical operations like medical drug processing to ensure compliance with regulations. Drive operational excellence by identifying process inefficiencies and systemic gaps across core pharmacy functions. Ensure that appealed decisions are updated/reflected in the system, and to internal staff as well as providers. Serve as primary point of contact for escalated pharmacy-related issues, discrepancies, pricing errors, and benefit configurations. Work with Pharmacy Benefits Mgr. (PBM) to resolve escalated issues. Directly communicate w/enterprise leaders/teams including UM, Claims, IT/Data, PBM, Compliance, Pharmacy, etc. Responsibilities * Engage with members on pharmacological escalations to resolve complaints. * Coordinate with PBM partners and internal departments (Claims, Configuration, Clinical and Legal) to ensure timely and accurate resolution of complex issues. * Maintain escalation logs, documentation, and resolution timelines to support compliance and trend analysis. * Direct, triage, and resolve escalations impacting providers and members, ensuring root cause analysis and corrective action plans. * Drive pharmacy operational readiness for new initiatives (PBM transitions, formulary changes, frozen formulary rules, state mandates. * Contribute to the development and maintenance of internal SOPs, escalation workflows, and FAQs for consistent issues handling. * Monitor daily rejected claims, accumulator discrepancies and eligibility-related fallouts queues to identify systemic issues and escalated as needed. * Contribute to operational dashboards and scorecards with experience-focus KPI(s). * Responsible for regulatory compliance and reporting; for managing insurance point of sale claims escalations; for analyzing financials and operations; and coordinating member outreach to ensure appropriate outcomes. * Provide weekly summaries or reporting packages to leadership outlining key findings, resolution status, and recommendations. * Support day-to-day operations across pharmacy benefit configuration group onboarding, adjustment claim submission and review, and file outbound and inbound validation. * Perform other projects and duties as assigned. * Support training efforts and knowledge-sharing for new staff or cross-functional partners regarding pharmacy operations and escalation protocols. Qualifications * Bachelor's degree * 5 - 8+ years of relevant, professional work experience (Required) * 5+ years of pharmacy operations experience (Required) * Additional years of related experience/specialized training may be considered in lieu of degree requirement (Required) * Ability to perform in office environment with extended periods of sitting, using telephone, and viewing computer screens (Required) * Ability to prioritize tasks daily and troubleshoot urgent customer issues to successful completion (Required) * Advanced knowledge of MS Office - Word, Excel, PowerPoint, Outlook, Teams, SharePoint, etc. (Required) * Exceptional problem solving, analytical, interpersonal and communication skills to resolve issues within Operations (Required) * Professionally skilled in verbal and written communication (Required) * Meticulous organization skills, with the ability to multi-task, and ability to make sound decisions in a timely and independent manner (Required) Additional Information * Requisition ID: 1000002784 * Hiring Range: $77,760-$149,040

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

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._

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._

Company :Allegheny Health NetworkJob Description : Allegheny Health Network (AHN) is building the future in its Imaging Institute by adding several services and locations to their network. Cardiothoracic Imaging is recruiting part-time and full-time thoracic and cardiothoracic radiologists for onsite/hybrid and remote positions. Job Duties: Reading options include 100% chest or a combination of chest and cardiac. Options to interpret body imaging are also available. Provide a wide range of diagnostic services including plain film, chest and cardiac CT (with cardiac CT, gated aortic CTA), and chest MR imaging (including cardiac MRI). Equipment includes over 11 CT scanners, including 3 Siemens dual source/energy Force CT scanners, Siemens Alpha Photon Counting CT, 128 slice CT, multiple 64 slice CT scanners, and 16 slice PET CT. Computed and digital radiography. Nine 1.5 Tesla magnets and Two 3 Tesla magnets. Participate fully in a large collaborative division which supplies services to 14 hospitals and imaging centers in the Greater Pittsburgh and Erie Areas. Interaction with residents who can assist with clinical care and provide preliminary interpretations. Schedule is very flexible with full shift or fractional daily shifts available. High level of collaboration with pulmonology, cardiology, and cardiothoracic surgery service lines Compensation Overview Salary Range: $420,000-$1,100,000 Competitive base salary with additional compensation for weekend call, value-based care and academic productivity, onsite coverage, and clinical productivity Reasonable wRVU requirements with opportunity for incentive over target RVU expectation (based on years of experience): 7,974-9,805 Signing and starting bonus eligibility AHN Proudly Offers Generous retirement benefits, including 401k (Roth or traditional), 457B, after-tax contributions, and employer match. Vested immediately Comprehensive benefits, including medical and dental insurance, life insurance, and disability insurance Malpractice coverage with tail coverage CME allowance Complimentary financial planning services. The position is eligible for the Public Service Loan Forgiveness (PSLF) program A diverse and inclusive workforce with respective loan repayment for qualified candidates Job Qualifications: Certified or eligible for certification by the American Board of Radiology in diagnostic radiology and Certificate of Added Qualification (CAQ) in cardiothoracic imaging Successful completion of fellowship training in cardiothoracic imaging Board Eligible/Board Certified in Radiology Doctor of Medicine (MD) or Doctor of Osteopathy (DO) Participation in Maintenance of Certification or eligibility for such is . Actively participate in the training program in terms of clinical and didactic teaching to the residents and medical students. Licensed in the state of Pennsylvania prior to employment Why AHN? AHN is a blended healthcare organization providing patients with exceptional healthcare for over a century. With a vertically integrated strategic partnership with Highmark Health, AHN is forging innovative solutions and key partnerships to help transform the health experience of our patients. This innovative approach by AHN+Highmark ensures a stable and robust health care system that provides top-notch care, supported by 14 hospitals, over 250 healthcare facilities, and 3,000+ physicians. Why Pittsburgh? Pittsburgh, PA, is a vibrant and dynamic environment with a rich cultural scene and a strong sense of community. Pittsburgh is a nationally recognized hub for medical, technological, and energy innovation. It also has a growing culinary scene, great sporting events, and many indoor/outdoor activities. The city's diverse neighborhoods and thriving job market make it an ideal place for healthcare professionals to grow. 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

Company :Highmark Inc. : This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides oversight over a specified panel of members that range in health status/severity and clinical needs; and assesses health management needs of the assigned member panel and utilizing data/analytics in conjunction with professional clinical judgement to identify the right clinical intervention for each member. The incumbent conducts outreach to members enrolled in case management including but is not limited to: developing a care plan, encouraging behavior changes, identifying and addressing barriers, helping members to coordinate care, and identifying various resources to assist members in achieving their personal health goals. Will work with providers to insure quality and appropriate care is being delivered in a timely manner. ESSENTIAL RESPONSIBILITIES Maintain oversight over specified panel of members by performing ongoing assessment of members' health management needs, identifying the right clinical interventions to address member needs and/or triaging members to appropriate resources for additional support. Implement care management review processes that are consistent with established industry, corporate, state, and federal law standards and are within the care manager's professional discipline. For assigned case load, create care plans to address members' identified needs, remove barriers to care, identify resources, and conduct a number of other activities to help improve the health outcomes of members; care plans include both long and short term goals and plan of regular contacts for re-assessment. Ensure all activities are documented and conducted in compliance with applicable business process requirements, regulatory requirements and accreditation standards. Other duties as assigned. EDUCATION Required High School/GED Substitutions None Preferred Bachelor's Degree in Nursing EXPERIENCE Required 7 years in any combination of clinical, case/utilization management and/or disease/condition management experience, or provider operations and/or health insurance experience 1 year in a clinical setting Preferred 5 years in UM/CM/QA/Managed Care 1 year in advanced training and experience in cognitive behavioral therapy (CBT), motivational interviewing or dialectical behavior therapy (DBT) 1 year working with the healthcare needs of diverse population and understanding of the importance of cultural competency in addressing targeted populations LICENSES or CERTIFICATIONS Required Current State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) or WV or DE or NY is required. Other RN license(s), if applicable, must be obtained within the first 6 months of employment. Preferred Certification in utilization management or a related field Certification in Case Management SKILLS Written and verbal presentation skills, negotiation skills, and skills in positively influencing others with respect and compassion Broad knowledge of disease processes Working knowledge of pertinent regulatory and compliance guidelines and medical policies Ability to multi task and perform in a fast paced and often intense environment Understanding of healthcare costs and the broader healthcare service delivery system Ability to analyze data, measure outcomes, and develop action plans Be enthusiastic, innovative, and flexible Be a team player who possesses strong analytical and organizational skills Demonstrated ability to prioritize work demands and meet deadlines Excellent computer and software knowledge and skills 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 Occasionally 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: $57,700.00 Pay Range Maximum: $107,800.00 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

Become a part of our caring community and help us put health first Humana is a publicly traded, Fortune 100 health benefits company with a long history of successful innovation and reinvention. It has transformed itself from the largest US nursing home company in the 60's, to the largest US hospital corporation in the 80's, to a leading health benefits company beginning in the 90's. Today, Humana is a leader in consumer-focused health solutions and is one of the largest health benefits organizations in the country. Consumer Segment Team Identifying and delivering new avenues of growth is a critical company priority. The Consumer Segment team is an entrepreneurial, multi-functional team within Humana's Medicare and Medicaid business unit. The team is focused on driving industry leading membership growth, retention and health outcomes by identifying new consumer insights, developing growth strategies, and activating them across the enterprise to serve the unique needs of prioritized segments. Humana is seeking an experienced team member with meaningful strategy consulting or healthcare strategy experience to join this team. As Strategy Advancement Advisor, you will support development and implementation of consumer segment strategies that drive growth and retention while optimizing member experience and outcomes. You'll collaborate with teammates and cross-functional partners to frame up business questions, conduct analyses, and recommend solutions. You will help answer key strategic business questions that arise during the annual product/sales cycle across multiple domains, including product design, plan footprint, marketing and sales performance, membership analytics, customer/provider satisfaction and more. You will proactively identify new consumer insights and create business cases to support new pilots and initiatives to address critical unmet consumer needs. Key Responsibilities Include: Managing analysis and/or work streams within high-profile, high-impact strategy projects Conducting industry, market, competitor, and financial analysis and deliverables that clearly frame objectives, issues/challenges, and articulate compelling, insightful findings, conclusions, and recommendations Conducting interviews, working sessions, and report-outs with associates and leaders across the company Own development and presentation of key deliverables for leadership and cross-functional partners Innovate new pilots and member experiences to drive growth and improved retention Support business case development for key initiatives Use your skills to make an impact Required Qualifications 7+ years of full-time relevant strategic work experience, ideally post-MBA Strategy management consulting experience Experience leading broad initiatives with cross-functional collaboration Strong problem-solving skills and the ability to perform complex qualitative and quantitative analysis Experience leveraging consumer insights to design and implement new products/services/solutions Proficiency in verbal/written communication to senior and executive leadership Proficient in delivering engaging and informative presentations to diverse audiences Preferred Qualifications MBA, MPH, PhD, or graduate degree in a management field Prior healthcare industry experience, preferably in the managed care or provider sector 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. $115,200 - $158,400 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 12-18-2025 About us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Company :en Gen : ***CANDIDATE MUST BE US Citizen (due to contractual/access requirements)*** This job turns data into information, information into insight, and insight into action. The incumbent leads teams and collaborates with business stakeholders to evaluate their need for information, identify potential solutions, gather and analyze data, and present conclusions in a concise and understandable format. The incumbent is expected to become intimately familiar with “the story of the business” as viewed through the lens of data, to champion the adoption of analytics as a tool for organizational change, and to serve as trusted advisors for all levels of management. ESSENTIAL RESPONSIBILITIES Evaluate a need for information: Coordinate with a broad spectrum of internal customer areas to identify complex business problems. Define the required outcomes and determine the ideal path toward achieving these outcomes. Lead teams to identify potential solutions: Evaluate new requirements against the tools, methods, and information currently available to solve the problem. Develop new tools and methods if necessary. Understand the interaction between new and existing solutions across the business. Gather and analyze data: Extract and transform data from all necessary sources. Foster relationships with data owners and become an expert on the information available in various data repositories. Be prepared to test established hypotheses, independently discover hidden patterns, and everything in between. Present conclusions to senior leadership in a concise and understandable format: Understand how to effectively communicate with customers in every possible medium, be it in-person conversations, phone calls, email, instant messages, presentations, or interactive dashboards. Use information design best practices to design content that is immediately understandable by the intended audience. Provide direction, guidance, and training to teammates with less experience. Serve as a project manager, assigning highly complex work and monitoring the accuracy and progress of the assigned work. Other duties as assigned. EDUCATION Required Bachelor's Degree in Statistics, Computer and Information Science, Mathematics or Information Technology Substitutions None Preferred None EXPERIENCE Required 7 - 10 years in Data Analytics OR 7 - 10 years in Business Intelligence Preferred Power BI Power Query LICENSES OR CERTIFICATIONS Required None Preferred None SKILLS Microsoft Office Communication Skills Analytical Skills Data Analysis Statistical Analysis Language None Travel Required 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 Yes Lifting: up to 10 pounds Does Not Apply Lifting: 10 to 25 pounds Does Not Apply Lifting: 25 to 50 pounds Does Not Apply 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

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 Elite Home Health, 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 a Business Office Assistant, you'll be the backbone of our administrative team, supporting the Admin, Director of Nursing (DON), and Office Manager with essential clerical and computer-related tasks. You'll keep things running smoothly by handling filing, shredding, data entry, and processing workflow tasks with precision and efficiency. Your role is crucial in ensuring our office operates seamlessly. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Assist with routine clerical/office tasks, answer telephone calls, and deliver messages + Pull, review, and follow up on reports of orders recert and unverified visits + Maintain up-to-date medical records by scanning documents timely and completing EOE audits + Complete discharge chart reviews, perform audits, process orders to/from physicians, and track for timely receipt + Communicate professionally within the organization and with external sources (physicians, patients, family members, referral sources, 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:** + Computer skills, clerical-business machine skills, telephone communication skills, and be able to type + General clerical skills and organizational skills **Preferred Qualifications:** + Able to work independently and as a team member *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.

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.

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 Revenue Cycle Director, Advisory Services is the overall project lead across our complex revenue cycle engagements, and is responsible for determining overall approach and structure of analysis for engagement and key deliverables. The Director serves as the driving force to assist healthcare provider clients across a range of complex traditional, strategic, and/or clinical revenue cycle projects. The Director assigns work streams to team members, sub-leads, and to his/her self that reflect skills and development needs while meeting the needs and timelines of the client. This role focuses on practice economics and will direct the team to follow the practices needed to ensure both quality and profitability. 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:** + Lead day-to-day activities for large, high complexity consulting projects with healthcare provider clients, providing project management, change management, and best practice expertise + Serve as member of Optum Advisory Sales, Utilization, and Profitability leadership team, comprised of all team members GL30+ to drive and support business development, successful and timely execution of projects, etc. + Serve as formal people manager to 1-3 Consultant and/or Project Lead level staff across GLs 27, 28, and 29 + Serve as principal point of day-to-day contact for client project lead across both diagnostic and implementation engagements alike + Gather needed data/information for the engagement and conduct appropriate analyses (e.g., cost/benefit analysis, benchmarking, requirements analysis, gap analysis) Cultivate the client's perception of Optum as a trusted partner and strategic advisor (e.g., build credibility, demonstrate full understanding of their business, leverage other resources within OptumInsight) + Drive high levels of client satisfaction by driving results that meet or exceed the client's expectations + Demonstrate strong relationship management skills and ability to handle challenging interpersonal situations with physicians, executives, colleagues, and peers + Collaborate with the client to confirm their expectations regarding key outcomes for the engagement + Identify/understand the client's business issues and size the financial impact associated with key performance improvement opportunities through financial analysis and scenario modeling + Identify and manage stakeholders to engage in applicable engagement activities (e.g., obtain buy-in, identify interviewees, provide needed information, influence others) + Establish optimal communication cadence with client and demonstrate sufficient executive presence to lead onsite presentations with C-Suite executives + Develop and present superior quality client deliverables + Identify/develop solutions to meet client needs (e.g., analytics, workflows, system selection and implementation, test plans, training plans) + Develop work plans for the engagement (e.g. project plans, staffing plans, budgets) and obtain appropriate buy-in and approvals + Manage engagement execution (e.g., status updates, reporting, risk management) and profitability, by managing successful project delivery within allotted project budget (managing billable hours utilized across the team) + Ensure engagement quality through running to criticism with both team members and clients alike, regularly seeking proactive feedback and adjusting course as needed based on feedback provided + Present engagement deliverables to applicable stakeholders (e.g. presentations, blueprints, staffing analytics, diagnostic findings and recommendations) + Prepare customized client recommendations to realize improvement opportunities identified based on industry best practices and emerging 'best-in-class' approaches and facilitate implementation of recommendations + Apply knowledge of change management principles to drive implementation of engagement objectives + Leverage project documents and deliverables to provide re-use/transferability for other engagements (e.g., de-identifying content, cataloguing deliverables, storing documents in appropriate shared folders) + Identify lessons learned and communicate to appropriate stakeholders across both internal team and client, as appropriate + Maintain ongoing contact with clients to identify and address emerging issues/concerns + Leverage and contribute to the applicable knowledge repositories (e.g., Microsoft Teams, SharePoint, asana, analysis tools, project toolkits) + Contribute to practice-level initiatives including business development and thought leadership beyond client project work + Stay current on important issues in the healthcare industry (e.g., political/ economic market forces, costs, capabilities, initiatives, legal/regulatory requirements) + Share professional and domain knowledge with peers and colleagues to build overall organization capabilities + Effectively delegate project work to internal team members + Coach and mentor junior staff and provide development support in enabling junior staff to grow professionally and develop new skill sets 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 healthcare revenue cycle consulting experience + Epic Revenue Cycle experience with certification in either HB Resolute or PB Resolute + Epic Revenue Cycle implementation experience + Client relationship management experience + Deep revenue cycle content expertise, with knowledge across both acute care and professional revenue cycle + Proficiency in MS Office Suite -Word, PowerPoint, Excel + Proven aptitude to support business development initiatives and working closely with teams to drive growth opportunities including speaking with clients at the Director and c-suite level + Proven solid critical thinking, relationship building, and storytelling skills + Proven ability to lead and motivate cross-functional teams + Proven ability to drill down to the root cause of client challenges and deploy creative problem solving + Proven exceptional written and verbal communication skills + Proven ability to drive quantifiable results + Willingness to travel domestically, up to 60% **Preferred Qualifications:** + Experience managing projects/teams that achieved budget, timeline and deliverable goals + Experience mentoring junior level staff + Solid healthcare industry knowledge + Proven to possess analytical reasoning and solution-focused problem solving + Proven ability to lead and motivate cross-functional teams *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 $132,200 to $226,600 annually based on full-time employment. We comply with all minimum wage laws as applicable. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._

Explore opportunities with [agency name], a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. 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. 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. 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 solid proficiency in Microsoft Office applications * Demonstrated ability to use modern accounting and financial software platforms and databases Preferred Qualifications: * Proven solid oral and written communication skills * Proven excellent interpersonal skills * Proven self-starter and self-motivated, able to consistently demonstrate these qualities in a fast-paced environment * Demonstrated 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 * 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.

You could be the one who changes everything for our 28 million members by using technology to improve health outcomes around the world. As a diversified, national organization, Centene's technology professionals have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Manages the team members accountable for designing, developing, and implementing complex enterprise software solutions. Collaborates closely with technical and non-technical roles such as data modelers, architects, business analysts, data stewards, and subject matter experts (SMEs) to provide design, technical analysis, development/configuration, testing, implementation, and support expertise representing the interest of the business across the enterprise. Serves in a team leadership capacity with large-scale Application Development projects / programs Leads the build-out or expansion of coding standards initiatives Reports application progress and outcomes Provides coaching and career development planning to junior Application Developers Coordinates the work of 3rd party Development teams, holds 3rd party vendors accountable to our standards, policies, and performance expectations. Identifies and evaluates risks and participates in mitigation and control activities Provides continuity with Application and Infrastructure Management operational groups during service transition Partners with Security and SRE teams, makes sure all security and change management policies are followed. Assists in the design and development of proof of concept and prototype application environments Manages the hiring and training of new and existing staff, conduct performance / salary reviews, and provide leadership, technical guidance and coaching to Developers executing all aspects of applications development Lead teams of Developers to help ensure the stable operation of application development activities Shares knowledge and develop staff capabilities to strengthen understanding of application development industry, business issues and best practices; evaluate implications to IT Develops and communicates departmental objectives; inspire and motivate team members to achieve results Holds teams accountable to meet functional, quality, and time line objectives. Performs other duties as assigned Complies with all policies and standards Education/Experience: Requires a Bachelor's degree and 5+ years of related experience. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. Technical Skills: One or more of the following skills are desired. Experience with Application Development; Applications Architecture Experience with Other: DevOps industry best practices Knowledge of Agile Software Development .NET Pay Range: $100,900.00 - $186,800.00 per year 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

Physician Pathways: Prepare for Day One at your practice up to one year in advance of completing your resident of fellowship program. As a Pathways Physician, you'll receive a salary, mentoring, and various other learning experiences focused on preparing for your career with the Optum American Health Network with minimal impact on your Resident training time. Interested in learning more about Value Based Care before day one? Getting to know your peers? Ease the stress of your transition to physician provider with an unparalleled head start **"virtually"** **Optum American Health Network Primary Care Physicians -- Indiana Pathways** --Plainfield, Peru, New Albany, Edinburgh-- For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start **Caring. Connecting. Growing together.** As a part of the Optum network, American Health Network is seeking career-minded Family Medicine or Internal Medicine residents who want to jump start their clinical career. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Position Highlights:** * Receive a generous guaranteed salary in your final year of training * Enhance the experience of your final months of training and eliminate the burden of job searching; employment is guaranteed at the completion of your residency * Learn how to practice and thrive in a value-based care model * Gain exposure to the Quadruple Aim framework and various understandings of care settings * Receive mentorship from experienced physicians within your future practice, easing your transition from training into practice * The customized program will be completed at American Health Network facilities in Indiana, or Ohio, and virtually * The program requires a commitment of only a few hours per month **What makes Optum different?** * Providers are supported to practice at the peak for their license * As one of the most dynamic and progressive health care organizations in the country, Optum consistently delivers clinical outcomes that meet or exceed national standards * We promote a culture of clinical innovation and transformation * We are a top performer nationally of the Quadruple Aim initiative * We are influencing change on a national scale while still maintaining the culture and community or our local organizations 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. **Key Takeaways:** * Optum fosters a collaborative culture focused on growth, innovation and mutually uplifting one another, enabling deep physician satisfaction * Tailored development programs like Physician Pathways smooth the transition from training to practice with expert mentorship * Physicians praise the supportive environment facilitating work-life balance, strong patient connections, and the ability to push care delivery boundaries **Required Qualifications:** * M.D. or D.O. * Must be transitioning into your final year of residency or fellowship **Preferred Qualification:** * Preferred candidate will be a local physician resident in Indiana--open to other areas as well The hourly range for this role is $39.90 to $59.86 per hour. 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. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by 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._

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 a Collection Specialist, you will take charge of preparing and processing a variety of insurance claims with precision. Each day, you ensure accuracy by actively verifying data through direct communication with agencies and external partners-keeping everything on track and moving forward. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. **Primary Responsibilities:** + Prepare and process various insurance claims, including electronic submissions for multiple payers + Verify claim data daily through communication with agencies and external personnel + Research and correct error claims to ensure clean claim production and submission + Review accounts receivable daily and follow up on delinquent accounts per established procedures + Recommend corrective actions based on account review findings + Investigate and respond to inquiries from payors and agencies regarding accounts receivable activity + Maintain and update accounts receivable schedules to track issues and resolutions for reporting + Resolve customer requests, inquiries, and concerns promptly and respectfully 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:** + 1+ years of medical billing and collections experience + Excellent oral and written communication skills + Solid organizational, analytical, and math skills + Basic proficiency in PC applications, including Microsoft Word and Excel **Preferred Qualifications:** + Home Health billing and collections experience *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The 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._