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  • Telephonic Case Manager RN Medical Oncology

    Unitedhealth Group 4.6company rating

    Remote or Atlanta, GA job

    The Telephonic Case Manager RN in Medical Oncology provides remote nursing support by coordinating patient care, educating members, and ensuring adherence to treatment plans. This role involves assessing patient health, identifying barriers, and connecting patients with necessary resources to improve health outcomes. Working primarily via telephone, the position requires strong clinical expertise, communication skills, and proficiency in healthcare technology systems. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. We're making a solid connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that's driving the health care industry forward. As a Telephone Case Manager RN with UnitedHealth Group, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today! The Telephonic Case Manager RN Medical/Oncology will identify, coordinate, and provide appropriate levels of care. The Telephonic Case Manager RN Medical/Oncology is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. This is a full-time, Monday - Friday, 8am-5pm position in your time zone. You'll enjoy the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: Make outbound calls and receive inbound calls to assess members current health status Identify gaps or barriers in treatment plans Provide patient education to assist with self-management Make referrals to outside sources Provide a complete continuum of quality care through close communication with members via in-person or on-phone interaction Support members with condition education, medication reviews and connections to resources such as Home Health Aides or Meals on Wheels This is high volume, customer service environment. You'll need to be efficient, productive and thorough dealing with our members over the phone. Solid computer and software navigation skills are critical. You should also be solidly patient-focused and adaptable to changes. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Current, unrestricted RN license in state of residence Active Compact RN License or ability to obtain upon hire 3+ years of experience in a hospital, acute care or direct care setting Proven ability to type and have the ability to navigate a Windows based environment Have access to high-speed internet (DSL or Cable) Dedicated work area established that is separated from other living areas and provides information privacy Preferred Qualifications BSN Certified Case Manager (CCM) 1+ years of experience within Medical/Oncology Case management experience Experience or exposure to discharge planning Experience in a telephonic role Background in managed care *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Keywords: telephonic case management, oncology nurse, patient education, care coordination, medical management, healthcare advocacy, remote nursing, chronic disease management, UnitedHealth Group, RN license
    $45k-53k yearly est. 5d ago
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  • Client Service Specialist (Life Insurance, Annuity & Disability) - Lincoln, NE

    Ameritas 4.7company rating

    Remote or Lincoln, NE job

    Back Client Service Specialist (Life Insurance, Annuity & Disability) #5661 Multiple Locations Apply X Facebook LinkedIn Email Copy Position Locations Lincoln, Nebraska, United StatesCincinnati, Ohio, United States Area of Interests Customer Service Full-Time/Part Time Full-time Job Description The Client Service Specialist (Life Insurance, Annuity, & Disability) will help drive the business by providing prompt, accurate and courteous service to build and maintain positive relationships with policyholders and field partners. At Ameritas, our mission is Fulfilling Life. We do that in many ways, but especially by helping people invest in themselves by offering trusted financial products and advice. Because we believe everyone should be happy, healthy, and financially secure, we work hard to provide trusted financial products and valued guidance, including individual life and disability insurance, employee benefits, retirement planning, investments, and wealth management services. This position will train as hybrid role (3 days in office per week) for the first 90 days and can be located in our Lincoln, NE or Cincinnati, OH office. After training, associates will have the opportunity to work in-office, hybrid, or fully remote. What you do: Communicate by telephone, e-mail, or other written correspondence with policyholders and field partners to expedite service requests for individual life, annuity, and disability policies. Understand and anticipate the needs of customers to deliver service that meets or exceeds expectations of clients and falls within stated department Service Standards. Communication must be pleasant, professional, tactful, and informative at all times. Obtain and analyze data from various sources to provide accurate and complete responses to agents and clients. The Associate must be able to analyze complex telephone inquiries and determine necessary steps for resolution including opening workflows and forwarding to appropriate team. Desire to have 1 st call resolution for every call and to complete customers request while on the phone. Must be able to prioritize multiple tasks and act with appropriate sense of urgency while shifting between processing and answering phone calls. What you bring: Associate's degree or equivalent experience required. 0-2 years of related experience required. Previous experience in a call center or customer service capacity highly preferred. Previous experience working in the insurance or financial services field is a plus. Series 6 or Series 99 license is preferred but not required. Must possess excellent verbal and written communication skills excellent telephone skills, problem solving, analytical and decision-making skills are required. Ability to prioritize tasks and consistently meet deadlines. Personal computer experience in database, spreadsheet, word processing and internet navigation software. Planning, organizational, and mathematical skills are important. What we offer: A meaningful mission. Great benefits. A vibrant culture Ameritas is an insurance, financial services and employee benefits provider Our purpose is fulfilling life. It means helping all kinds of people, at every age and stage, get more out of life. At Ameritas, you'll find energizing work challenges. Flexible hybrid work options. Time for family and community. But dig deeper. Benefits at Ameritas cover things you expect -- and things you don't: Ameritas Benefits For your money: * 401(k) Retirement Plan with company match and quarterly contribution. * Tuition Reimbursement and Assistance. * Incentive Program Bonuses. * Competitive Pay. For your time: * Flexible Hybrid work. * Thrive Days - Personal time off. * Paid time off (PTO). For your health and well-being: * Health Benefits: Medical, Dental, Vision. * Health Savings Account (HSA) with employer contribution. * Well-being programs with financial rewards. * Employee assistance program (EAP). For your professional growth: * Professional development programs. * Leadership development programs. * Employee resource groups. * StrengthsFinder Program. For your community: * Matching donations program. * Paid volunteer time- 8 hours per month. For your family: * Generous paid maternity leave and paternity leave. * Fertility, surrogacy, and adoption assistance. * Backup child, elder and pet care support. An Equal Opportunity Employer Ameritas has a reputation as a company that cares, and because everyone should feel safe bringing their authentic, whole self to work, we're committed to an inclusive culture and diverse workplace, enriched by our individual differences. We are an Equal Opportunity/Affirmative Action Employer that hires based on qualifications, positive attitude, and exemplary work ethic, regardless of sex, race, color, national origin, religion, age, disability, veteran status, genetic information, marital status, sexual orientation, gender identity or any other characteristic protected by law. Application Deadline This position will be open for a minimum of 3 business days or until filled. This position is not open to individuals who are temporarily authorized to work in the U.S. About this Position's Pay The pay range posted reflects a nationwide minimum to maximum covering all potential locations where the position may be filled. The final determination on pay for any position will be based on multiple factors including role, career level, work location, skill set, and candidate level of experience to ensure pay equity within the organization. This position will be eligible to participate in our comprehensive benefits package (see above for details). This position will be eligible to participate in our Short-Term Incentive Plan with the annual target defined by the plan. Job Details Pay Range Pay RangeThe estimated pay range for this job. Disclosing pay information promotes competitive and equitable pay. The actual pay rate will depend on the person's qualifications and experience. $18.32 - $29.31 / hour Pay Transparency Pay transparency is rooted in principles of fairness, equity, and accountability within the workplace. Sharing pay ranges for job postings is one way Ameritas shows our commitment to equitable compensation practices.
    $18.3-29.3 hourly 2d ago
  • Regional Sales Representative- Northern California / Sacramento - Remote, AZ

    Ameritas 4.7company rating

    Remote or Phoenix, AZ job

    Back Regional Sales Representative- Northern California / Sacramento #5555 Remote, Arizona, United States Apply X Facebook LinkedIn Email Copy Position Locations Remote, Arizona, United States Area of Interests Sales Full-Time/Part Time Full-time Job Description Position Description: Ameritas is seeking a Regional Sales Representative to join a dynamic and collaborative team. In this role, you will build and maintain strong business relationships with brokers, agents and other insurance professionals to meet or exceed established sales goals, quotas, targets or objectives within your assigned territory. You will focus on selling Dental, Vision and Hearing employee benefit products. This position will focus on covering Northern California and Sacramento. At Ameritas, our mission is Fulfilling Life. We do that in many ways, but especially by helping people invest in themselves by offering trusted financial products and advice. Because we believe everyone should be happy, healthy, and financially secure, we work hard to provide trusted financial products and valued guidance, including individual life and disability insurance, employee benefits, retirement planning, investments, and wealth management services. Position Location: This position is remote and does not require regular in-office presence. The ideal candidate will be located in Sacramento, CA or the greater Bay Area. What you do: Develop and maintain multiple business relationships to meet or exceed established sales goals, quotas, or objectives within your assigned territory. Develop a clear understanding of Ameritas business, our diverse Group products, the complex business relationships within the brokerage community and the clients we service. Support new sales initiatives to increase sales of existing products and/or develop sales of new products. Collaborates with internal stakeholders to ensure the proper processing of all sold products from time of sale to issuance. Identify and procure new customer sales opportunities in partnership with brokers in territory Manage the inforce block of business to build new/integrated sales opportunities with existing clients Build, maintain and enhance strong producer relationships through superior product and services knowledge, territory management practices, and excellent customer service. What you bring: Bachelor's degree or equivalent work experience Ability to learn the insurance/financial services industry, including products and marketing practices Ability to demonstrate a leadership presence with internal and external partners with strong ability to create relationships and be a team player Excellent interpersonal, presentation and collaboration skills. Highly energized, motivated, results oriented self-starter with problem-solving skills. Excellent time management, organization, and project management abilities Ability to work with a team to achieve optimal results. What we offer: A meaningful mission. Great benefits. A vibrant culture Ameritas is an insurance, financial services and employee benefits provider Our purpose is fulfilling life. It means helping all kinds of people, at every age and stage, get more out of life. At Ameritas, you'll find energizing work challenges. Flexible hybrid work options. Time for family and community. But dig deeper. Benefits at Ameritas cover things you expect -- and things you don't: Ameritas Benefits For your money: 401(k) Retirement Plan with company match and quarterly contribution Tuition Reimbursement and Assistance Incentive Program Bonuses Competitive Pay For your time: Flexible Hybrid work Thrive Days - Personal time off Paid time off (PTO) For your health and well-being: Health Benefits: Medical, Dental, Vision Health Savings Account (HSA) with employer contribution Well-being programs with financial rewards Employee assistance program (EAP) For your professional growth: Professional development programs Leadership development programs Employee resource groups StrengthsFinder Program For your community: Matching donations program Paid volunteer time- 8 hours per month For your family: Generous paid maternity leave and paternity leave Fertility, surrogacy and adoption assistance Backup child, elder and pet care support An Equal Opportunity Employer Ameritas has a reputation as a company that cares, and because everyone should feel safe bringing their authentic, whole self to work, we're committed to an inclusive culture and diverse workplace, enriched by our individual differences. We are an Equal Opportunity/Affirmative Action Employer that hires based on qualifications, positive attitude, and exemplary work ethic, regardless of sex, race, color, national origin, religion, age, disability, veteran status, genetic information, marital status, sexual orientation, gender identity or any other characteristic protected by law. About this Position's Pay This is a sales position. The posted range reflects the base pay and variable compensation. The pay range posted reflects a nationwide minimum to maximum covering all potential locations where the position may be filled. The final determination on base pay for any position will be based on multiple factors including role, career level, work location, skill set, and candidate level of experience to ensure pay equity within the organization. This position will be eligible to participate in our comprehensive benefits package (see above for details). This position will be eligible to participate in our variable compensation program with a target defined by the applicable program. Job Details Pay Range Pay RangeThe estimated pay range for this job. Disclosing pay information promotes competitive and equitable pay. The actual pay rate will depend on the person's qualifications and experience. $71,000.00 - $178,000.00 / year Pay Transparency Pay transparency is rooted in principles of fairness, equity, and accountability within the workplace. Sharing pay ranges for job postings is one way Ameritas shows our commitment to equitable compensation practices.
    $56k-70k yearly est. 3d ago
  • Lead Plan Compliance Administration Analyst - Retirement Plans - Remote USAPosition-Ameritas HQ is Lincoln, NE

    Ameritas 4.7company rating

    Remote or Lincoln, NE job

    Back Lead Plan Compliance Administration Analyst - Retirement Plans #5624 Remote USA Position-Ameritas HQ is Lincoln, Nebraska, United States Apply X Facebook LinkedIn Email Copy Position Locations Remote USA Position-Ameritas HQ is Lincoln, Nebraska, United States Area of Interests Retirement Plans Full-Time/Part Time Full-time Job Description Position Description: The position serves as a subject matter expert for a plan compliance administration team and is responsible for delivery of technical administrative services to qualified retirement plans. This position is accountable for ensuring the day-to-day business needs are being met for their own workload. This position will provide associate training, meeting facilitation, and development/implementation of workflow process improvement. This position also supports the daily activity of the team through team standards, answering processing or escalation questions, and acting as subject matter expert as needed to meet team and Retirement Plan division goals. Position Location: This position is remote (within the U.S.A.) and does not require regular in-office presence. What you do Produce weekly and monthly reporting to ensure that goals are being met. Manage difficult and complex plans while working outside of the pooled environment. Provide guidance to resolve escalated issues or concerns. Serve as leader and subject matter expert to team ensuring accuracy, providing service on escalated issues, onboarding, and training of the team. Ensure adherence to regulations, policies, and procedures. Recommend innovative programs or processes to achieve results. Monitor daily operational activity and provide directions to meet service goals. Lead and oversee high profile RP & team projects. Communicate by phone or written correspondence with plan sponsors and their advisors regarding compliance related matters. Administer large and complex plans according to plan documents. Calculate employer contributions, including cross-tested plans. Prepare earned income calculations. Perform annual plan compliance testing, including ADP/ACP, Top Heavy, 410(b), 401(a)(4) and 402(g) and work with clients on corrective measures for failed tests. Prepare and file Forms 5500 and 5330. Provide support for plan audits. Utilize multiple systems to administer plans efficiently and by regulatory deadlines. Guide clients through correction programs such as EPCRS and DFVC. Research plan related compliance matters using available resources. What you bring Bachelor's Degree or equivalent experience required 3-5 years Retirement Plans Administration experience Ability to manage data and process financial transactions with a high degree of accuracy Ability to maintain data security by following all data security guidelines and by bringing any potential security threats to the appropriate contact's attention for further review Excellent mathematical and Excel skills Excellent communication skills Ability to work under tight deadlines Attention to detail Problem solving abilities QKA or equivalent designation preferred What we offer: A meaningful mission. Great benefits. A vibrant culture Ameritas is an insurance, financial services and employee benefits provider Our purpose is fulfilling life. It means helping all kinds of people, at every age and stage, get more out of life. At Ameritas, you'll find energizing work challenges. Flexible hybrid work options. Time for family and community. But dig deeper. Benefits at Ameritas cover things you expect -- and things you don't: Ameritas Benefits For your money: 401(k) Retirement Plan with company match and quarterly contribution Tuition Reimbursement and Assistance Incentive Program Bonuses Competitive Pay For your time: Flexible Hybrid work Thrive Days - Personal time off Paid time off (PTO) For your health and well-being: Health Benefits: Medical, Dental, Vision Health Savings Account (HSA) with employer contribution Well-being programs with financial rewards Employee assistance program (EAP) For your professional growth: Professional development programs Leadership development programs Employee resource groups StrengthsFinder Program For your community: Matching donations program Paid volunteer time- 8 hours per month For your family: Generous paid maternity leave and paternity leave Fertility, surrogacy and adoption assistance Backup child, elder and pet care support An Equal Opportunity Employer Ameritas has a reputation as a company that cares, and because everyone should feel safe bringing their authentic, whole self to work, we're committed to an inclusive culture and diverse workplace, enriched by our individual differences. We are an Equal Opportunity/Affirmative Action Employer that hires based on qualifications, positive attitude, and exemplary work ethic, regardless of sex, race, color, national origin, religion, age, disability, veteran status, genetic information, marital status, sexual orientation, gender identity or any other characteristic protected by law. About this Position's Pay The pay range posted reflects a nationwide minimum to maximum covering all potential locations where the position may be filled. The final determination on pay for any position will be based on multiple factors including role, career level, work location, skill set, and candidate level of experience to ensure pay equity within the organization. This position will be eligible to participate in our comprehensive benefits package (see above for details). This position will be eligible to participate in our Short-Term Incentive Plan with the annual target defined by the plan. Job Details Pay Range Pay RangeThe estimated pay range for this job. Disclosing pay information promotes competitive and equitable pay. The actual pay rate will depend on the person's qualifications and experience. $65,382.00 - $107,880.00 / year Pay Transparency Pay transparency is rooted in principles of fairness, equity, and accountability within the workplace. Sharing pay ranges for job postings is one way Ameritas shows our commitment to equitable compensation practices.
    $65.4k-107.9k yearly 3d ago
  • Primary Care Advanced Practice Clinician (NP/PA) - EMR Support, Corvallis - Remote within Oregon

    Unitedhealth Group Inc. 4.6company rating

    Remote or Corvallis, OR job

    Explore opportunities at The Corvallis Clinic, part of the Optum family of businesses. For more than 75 years, our multi-specialty group has been committed to delivering exceptional care to our patients and fulfilling careers to our team members. As a leading clinic in Oregon's mid-Willamette Valley, we serve more than a quarter-million people with offices in Corvallis, Albany and Philomath. Join a team that empowers you from the start and values work-life balance, teamwork and trust. We offer comprehensive benefits and competitive pay. Elevate your career with us and discover the meaning behind Caring. Connecting. Growing together. If you are located within the state of Oregon, you will have the flexibility to work remotely* as you take on some tough challenges. Position Highlights: Full Time 40 weekly hours, M-F, 8am-5 pm 95% work from home, after initial onsite training (3-6 months) All equipment provided 75% inbox management and 25% telemedicine patient care Live locally within commuting distance to Mid-Willamette Valley Assessing Red Flag calls escalated from nurse triage and determine appropriate level of care Tech savvy, Athena EMR Tele-med acute care phone and video visits Opportunity for growth What makes an Optum organization different? As the largest employer of Advanced Practice Clinicians, we have a best-in-class employee experience and enable you to practice at the top of your license We believe that better care for clinicians equates to better care for patients We are influencing change collectively on a national scale while still maintaining the culture and community of our local care organizations We grow talent from within. No matter where you want to go- geographically or professionally- you can do it here You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Master's degree from a four-year college and/or a professional certification beyond a four-year college AANC or AANP certified family nurse practitioner or NCCPA certified physician associate Active Unrestricted Oregon State Nurse Practitioner or Physician Assistant License or ability to obtain prior to employment Current Oregon DEA certificate or the ability to obtain prior to employment Access to reliable high-speed internet Able to work well with others in a team environment Live locally within commuting distance to Corvallis\Albany, OR Preferred Qualifications: 2+ years of clinical practice experience Urgent Care or ER experience Solid understanding of examination methodologies and diagnostics Proficiency in common medication indications, side effects, and contraindications Confidence with clinical decision making over telephone visit All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Compensation for this specialty generally ranges from $104,500 - $156,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
    $104.5k-156k yearly 5d ago
  • Sr Utilization Management Nurse - Remote in Massachusetts

    Unitedhealth Group 4.6company rating

    Remote or Boston, MA job

    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** For the role, there will be no weekends, no holidays, and no on-call work. We serve the Commonwealth of Massachusetts in partnering with onsite audits and projects. We have collaborative team scheduling and there is an occasional opportunity for remote work based on business needs. If you are located in Massachusetts, you will have the flexibility to work remotely* as you take on some tough challenges. **Primary Responsibilities:** + Audit entire medical record for accuracy of the coding on the MDS/ MMQ to support payment to the nursing facility + Discuss Patient Care specifics with peers or providers in overall patient care and benefits + Communicate clinical findings and present rationale for decisions to medical professionals and members at the appropriate level for understanding + Review the entire medical record for accuracy, and appropriate clinical treatment + Communicate findings of audits to client, and community as needed + Education of findings with community, identifying plans for correction + Comply with HIPAA guidelines related to Personal Health Information (PHI) when communicating with others + Leverage experience and understanding of disease pathology to review chart/clinical information, ask appropriate questions, and identify appropriate course of care in a given situation + Perform medical chart review that includes a review of current and prior patient conditions, documents, and evaluations, and relevant social and economic situations to identify patients' needs + Research and identify information needed to review assessment for accuracy, respond to questions, or make recommendations + Apply knowledge of pharmacology and clinical treatment protocol to determine appropriateness of care + Work collaboratively with peers/team members and other levels or segments within Optum, UHC, or UBH (e.g. Case Managers, Field Care Advocates) to identify appropriate course of action (e.g. Appropriate care, follow up course of action, make referral) + Required to travel within geographic territory 75% of the time and assist when needed throughout the state of Massachusetts for audits. (Audits will be conducted onsite) 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:** + Undergraduate degree or 4+ years of equivalent nursing experience + Current unrestricted RN nurse license in Massachusetts + MDS certification or must obtain and provide proof prior to start date + Recent long-term care MMQ, MDS, staff development or management experience (in long-term care) + Experience working within medical insurance and/or healthcare industries + Experience analyzing inventory, researching, identifying, and resolving issues + Experience with defining and managing processes within a team + Experience trouble shooting issues for users within teams, IT and or business partners + Proven knowledge of healthcare insurance industry (Medicaid, Medicare, CMS) + Demonstrated knowledge of process flow of UM including prior authorization, concurrent authorization, and/or clinical appeal and guidance reviews + Proficient in Microsoft Office + Proficient written and verbal skills + Ability to travel within geographic territory (state of Massachusetts) up to 90% of the time and assist when needed throughout the state of Massachusetts for audits. (Audits will be conducted onsite) + Driver's License and access to reliable transportation **Preferred Qualifications:** + Proven knowledge of Medicaid and Medicare benefit products including applicable state regulations + Demonstrated knowledge of applicable area of specialization + Demonstrated knowledge of Massachusetts DPH guidelines + Demonstrated knowledge of computer functionality, navigation, and software applications *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. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
    $71.2k-127.2k yearly 2d ago
  • Director of Automation & Operational Excellence (Remote)

    Unitedhealth Group 4.6company rating

    Remote or Wausau, WI job

    A leading healthcare company is seeking a Director - Automations & Efficiencies to lead innovative projects aimed at enhancing operational effectiveness. This role involves overseeing automation initiatives in a healthcare environment, managing strategic partnerships, and improving processes through advanced technologies. The ideal candidate has significant experience in healthcare payer operations, RPA technologies, and cross-functional leadership. This position offers flexibility to work remotely from anywhere within the U.S. #J-18808-Ljbffr
    $97k-116k yearly est. 2d ago
  • Lead Coordinator, Sales Support and Operations - Retirement Plans - Remote USAPosition-Ameritas HQ is Lincoln, NE

    Ameritas 4.7company rating

    Remote or Lincoln, NE job

    Back Lead Coordinator, Sales Support and Operations - Retirement Plans #5662 Remote USA Position-Ameritas HQ is Lincoln, Nebraska, United States Apply X Facebook LinkedIn Email Copy Position Locations Remote USA Position-Ameritas HQ is Lincoln, Nebraska, United States Area of Interests Retirement Plans Full-Time/Part Time Full-time Job Description This position takes lead on support services to the Retirement Plans sales force to achieve sales objectives and drive revenue. Maintain positive relationships with internal and external contacts to achieve customer retention. As a subject matter expert regarding Retirement Plans products and programs, this role works independently, utilizing comprehensive knowledge to solve complex service issues, delegate tasks, or review products of other associates. This position is remote (within the U.S.A.) and does not require regular in-office presence. What you do: Lead service functions to support sales teams including timely and accurate preparation of materials, proposals, client data, and other sales information. Oversee processes to maintain data, respond to inquiries, and deliver solutions to support the sales teams. Manage progress during the entire lifecycle of a case. Take lead on department projects or inquiries that are complex and deliver guidance and solutions. Identify and make recommendations to resolve procedural or system related problems. Train and review work products of new or entry level associates. Maintain a comprehensive understanding of various insurance products and their features and limitations. TPA (Third Party Administrator) strategist Work with TPA advisory council on monthly communications. Work on TPA campaigns. Act as sales liaison with TPA services. National Accounts reporting Maintain and produce monthly data reports for Broker Dealers. Maintain and produce annual RFI (Request for Information) and due diligence reports. Salesforce reporting. Regional Sales Coordinator support Assist with PEP proposal processes. What you bring: 4 years of overall experience required. 2 years of experience with retirement plans required. High school diploma or GED required. Demonstrated ability to perform administrative tasks with a high level of accuracy and attention to detail required. What we offer: A meaningful mission. Great benefits. A vibrant culture Ameritas is an insurance, financial services and employee benefits provider Our purpose is fulfilling life. It means helping all kinds of people, at every age and stage, get more out of life. At Ameritas, you'll find energizing work challenges. Flexible hybrid work options. Time for family and community. But dig deeper. Benefits at Ameritas cover things you expect -- and things you don't: Ameritas Benefits For your money: * 401(k) Retirement Plan with company match and quarterly contribution. * Tuition Reimbursement and Assistance. * Incentive Program Bonuses. * Competitive Pay. For your time: * Flexible Hybrid work. * Thrive Days - Personal time off. * Paid time off (PTO). For your health and well-being: * Health Benefits: Medical, Dental, Vision. * Health Savings Account (HSA) with employer contribution. * Well-being programs with financial rewards. * Employee assistance program (EAP). For your professional growth: * Professional development programs. * Leadership development programs. * Employee resource groups. * StrengthsFinder Program. For your community: * Matching donations program. * Paid volunteer time- 8 hours per month. For your family: * Generous paid maternity leave and paternity leave. * Fertility, surrogacy, and adoption assistance. * Backup child, elder and pet care support. An Equal Opportunity Employer Ameritas has a reputation as a company that cares, and because everyone should feel safe bringing their authentic, whole self to work, we're committed to an inclusive culture and diverse workplace, enriched by our individual differences. We are an Equal Opportunity/Affirmative Action Employer that hires based on qualifications, positive attitude, and exemplary work ethic, regardless of sex, race, color, national origin, religion, age, disability, veteran status, genetic information, marital status, sexual orientation, gender identity or any other characteristic protected by law. Application Deadline This position will be open for a minimum of 3 business days or until filled. This position is not open to individuals who are temporarily authorized to work in the U.S. About this Position's Pay The pay range posted reflects a nationwide minimum to maximum covering all potential locations where the position may be filled. The final determination on pay for any position will be based on multiple factors including role, career level, work location, skill set, and candidate level of experience to ensure pay equity within the organization. This position will be eligible to participate in our comprehensive benefits package (see above for details). This position will be eligible to participate in our Short-Term Incentive Plan with the annual target defined by the plan. Job Details Pay Range Pay RangeThe estimated pay range for this job. Disclosing pay information promotes competitive and equitable pay. The actual pay rate will depend on the person's qualifications and experience. $24.23 - $38.76 / hour Pay Transparency Pay transparency is rooted in principles of fairness, equity, and accountability within the workplace. Sharing pay ranges for job postings is one way Ameritas shows our commitment to equitable compensation practices.
    $24.2-38.8 hourly 2d ago
  • Lead Transition Consultant - Retirement Plans - Remote USA Position-Ameritas HQis Lincoln, NE

    Ameritas 4.7company rating

    Remote or Lincoln, NE job

    Back Lead Transition Consultant - Retirement Plans #5663 Remote USA Position-Ameritas HQ is Lincoln, Nebraska, United States Apply X Facebook LinkedIn Email Copy Position Locations Remote USA Position-Ameritas HQ is Lincoln, Nebraska, United States Area of Interests Retirement Plans Full-Time/Part Time Full-time Job Description Position Description: This position serves as the primary liaison between the financial professional, client, regional director, and internal partners during the plan installation and conversion. This position is responsible for the installation of all new retirement plans. This role develops and maintains professional relationships with financial professionals and clients to ensure required services are being provided to the client. As the client's first impression of the home office, this position is responsible for ensuring a smooth transition from sale to service. Position Location: This position is remote (USA) and does not require regular in-office presence. What you do: Develop relationships with plan sponsors, financial professionals, & TPAs. Coordinate the transfer of plan assets, generate affiliated notices, and direct allocation of transferred assets. Support and coordinate with the sales team for assigned region. Advocate the implementation process to internal and external parties including but not limited to associates, financial professionals, TPAs, and clients. Own timely, professional, and accurate resolutions to client concerns, questions, and problems possibly during high stress situations. Drive client service initiatives including process improvement to enhance client experience. Maintain risk awareness and regulatory knowledge. Coordinate changes required by the compliance team based on legally required changes. Allocate and verify asset transfers ensuring money has been allocated appropriately and balances are correct. Ensure smooth transition for on-going service through conversion of plan to the client service team(s). What you bring: Bachelor's Degree (preferably in business or finance) or equivalent combination of education and experience required. 3 -5 of relevant retirement plans experience required including: Extensive knowledge of relevant complex legal requirements and contracts. Retirement plans implementation experience. MEP (multiple employer plan), PEP (pooled employer plan), and/or PEO (professional employer organization) experience desired. Less than 2 years' experience coaching others QKA-Qyalified 401(k) Administrator or other ASPPA certification What we offer: A meaningful mission. Great benefits. A vibrant culture Ameritas is an insurance, financial services, and employee benefits provider Our purpose is fulfilling life. It means helping all kinds of people, at every age and stage, get more out of life. At Ameritas, you'll find energizing work challenges. Flexible hybrid work options. Time for family and community. But dig deeper. Benefits at Ameritas cover things you expect -- and things you don't: Ameritas Benefits For your money: 401(k) Retirement Plan with company match and quarterly contribution Tuition Reimbursement and Assistance Incentive Program Bonuses Competitive Pay For your time: Flexible Hybrid work Thrive Days - Personal time off Paid time off (PTO) For your health and well-being: Health Benefits: Medical, Dental, Vision Health Savings Account (HSA) with employer contribution Well-being programs with financial rewards Employee assistance program (EAP) For your professional growth: Professional development programs Leadership development programs Employee resource groups StrengthsFinder Program For your community: Matching donations program Paid volunteer time - 8 hours per month For your family: Generous paid maternity leave and paternity leave Fertility, surrogacy and adoption assistance Backup child, elder and pet care support An Equal Opportunity Employer Ameritas has a reputation as a company that cares, and because everyone should feel safe bringing their authentic, whole self to work, we're committed to an inclusive culture and diverse workplace, enriched by our individual differences. We are an Equal Opportunity/Affirmative Action Employer that hires based on qualifications, positive attitude, and exemplary work ethic, regardless of sex, race, color, national origin, religion, age, disability, veteran status, genetic information, marital status, sexual orientation, gender identity or any other characteristic protected by law. Application Deadline This position will be open for a minimum of 3 business days or until filled. This position is not open to individuals who are temporarily authorized to work in the U.S. About this Position's Pay The pay range posted reflects a nationwide minimum to maximum covering all potential locations where the position may be filled. The final determination on pay for any position will be based on multiple factors including role, career level, work location, skill set, and candidate level of experience to ensure pay equity within the organization. This position will be eligible to participate in our comprehensive benefits package (see above for details). This position will be eligible to participate in our Short-Term Incentive Plan with the annual target defined by the plan. Job Details Pay Range Pay RangeThe estimated pay range for this job. Disclosing pay information promotes competitive and equitable pay. The actual pay rate will depend on the person's qualifications and experience. $65,382.00 - $107,880.00 / year Pay Transparency Pay transparency is rooted in principles of fairness, equity, and accountability within the workplace. Sharing pay ranges for job postings is one way Ameritas shows our commitment to equitable compensation practices.
    $65.4k-107.9k yearly 2d ago
  • Market Development Specialist - Remote USA Position-Ameritas HQ is Lincoln, NE

    Ameritas 4.7company rating

    Remote or Lincoln, NE job

    Back Market Development Specialist #5660 Remote USA Position-Ameritas HQ is Lincoln, Nebraska, United States Apply X Facebook LinkedIn Email Copy Position Locations Remote USA Position-Ameritas HQ is Lincoln, Nebraska, United States Area of Interests Sales Full-Time/Part Time Full-time Job Description This individual will focus on securing new institutional and adopting employer sales for Ameritas. The position will establish new relationships as well as managing and driving greater sales within existing relationships. This position will have a heavy focus on the PEO, Association, MEP and PEP market. The Market Development Specialist is responsible for attaining the assigned annual sales goal by developing, supporting, and driving sales through key strategic relationships and increasing the number of adopting employers. These key relationships will include existing PEO/Association clients, PEO industry organizations (NAPEO, PACE, FAPEO), HRIS providers (PrismHR, iSolved), and other key intermediaries. In addition, this role will assist the Ameritas Retirement Plans Sales team with establishing new MEPs or PEPs, including coordinating the Sales paperwork and onboarding process. Utilize verbal skills to communicate effectively to a wide array of distribution partners, while using effective listening and troubleshooting skills to help them solve for their problems. This role will be a good fit for someone who can demonstrate high levels of professionalism, sound judgment, strong analytical skills, prioritization and time management skills, and exemplary teamwork. To achieve the goals and priorities established the incumbent must exercise a great deal of personal discretion and judgment in maintaining objectivity among many groups/individuals, to communicate in a diplomatic manner, to effectively handle changing and/or stressful situations as well as to diffuse conflict and negotiate win-win outcomes. This position is remote (within the U.S.A.) and does not require regular in-office presence. What you do: Partner with the Sales Director to prospect various distribution channels for institutional sales. Develop and execute on client specific business plans for institutional sales designed to maximize results over time. Proactively prospect and onboard new adopting employers for new and existing PEO, Association, MEP and PEP relationships. Meet and exceed activity metrics as developed by VP of Sales. Prepare and present proposals for Ameritas Retirement Plan products and services. Partner with internal wholesaler (Regional Sales Consultant) and VP of Sales for development and execution of business strategy that produces maximum results. Act as liaison between the client and Home Office as needed to ensure success. Continuously enhance skills and retirement plan knowledge through professional development activities (Reading, formal/informal education, training classes, special projects/assignments). Meet or exceed the annual sales objectives for the Institutional Sales team. Communicate regularly with key internal partners, including but not limited to external sales reps, internal sales reps, relationship managers, and other key distribution personnel. Develop/generate sales ideas and materials as needed to achieve results. Gather and document competitive intelligence and industry insights for Senior Management and Field Partners. Document all pertinent interaction and update any changes in the CRM system (SalesForce.com). Maintain and update pipeline activity in CRM. Perform other duties as assigned. What you bring: Bachelor's degree or equivalent combination of education and experience required. 4+ years of retirement plan industry and/or financial services industry knowledge and experience required. Previous sales experience required. Proactive selling skills are very important. Ability to analyze complex situations desired. Life insurance license required. If not currently held, must be willing to obtain license within 6 months. FINRA Series 6 or 7 licenses are required. If not currently held, must be willing to obtain licenses within 6 months. Ability to travel nationally 25%-50% of the time is required. What we offer: A meaningful mission. Great benefits. A vibrant culture Ameritas is an insurance, financial services and employee benefits provider Our purpose is fulfilling life. It means helping all kinds of people, at every age and stage, get more out of life. At Ameritas, you'll find energizing work challenges. Flexible hybrid work options. Time for family and community. But dig deeper. Benefits at Ameritas cover things you expect -- and things you don't: Ameritas Benefits For your money: * 401(k) Retirement Plan with company match and quarterly contribution. * Tuition Reimbursement and Assistance. * Incentive Program Bonuses. * Competitive Pay. For your time: * Flexible Hybrid work. * Thrive Days - Personal time off. * Paid time off (PTO). For your health and well-being: * Health Benefits: Medical, Dental, Vision. * Health Savings Account (HSA) with employer contribution. * Well-being programs with financial rewards. * Employee assistance program (EAP). For your professional growth: * Professional development programs. * Leadership development programs. * Employee resource groups. * StrengthsFinder Program. For your community: * Matching donations program. * Paid volunteer time- 8 hours per month. For your family: * Generous paid maternity leave and paternity leave. * Fertility, surrogacy, and adoption assistance. * Backup child, elder and pet care support. An Equal Opportunity Employer Ameritas has a reputation as a company that cares, and because everyone should feel safe bringing their authentic, whole self to work, we're committed to an inclusive culture and diverse workplace, enriched by our individual differences. We are an Equal Opportunity/Affirmative Action Employer that hires based on qualifications, positive attitude, and exemplary work ethic, regardless of sex, race, color, national origin, religion, age, disability, veteran status, genetic information, marital status, sexual orientation, gender identity or any other characteristic protected by law. Application Deadline This position will be open for a minimum of 3 business days or until filled. This position is not open to individuals who are temporarily authorized to work in the U.S. About this Position's Pay This is a sales position. The posted range reflects the base pay and variable compensation. The pay range posted reflects a nationwide minimum to maximum covering all potential locations where the position may be filled. The final determination on base pay for any position will be based on multiple factors including role, career level, work location, skill set, and candidate level of experience to ensure pay equity within the organization. This position will be eligible to participate in our comprehensive benefits package (see above for details). This position will be eligible to participate in our variable compensation program with a target defined by the applicable program. Job Details Pay Range Pay RangeThe estimated pay range for this job. Disclosing pay information promotes competitive and equitable pay. The actual pay rate will depend on the person's qualifications and experience. $71,000.00 - $178,000.00 / year Pay Transparency Pay transparency is rooted in principles of fairness, equity, and accountability within the workplace. Sharing pay ranges for job postings is one way Ameritas shows our commitment to equitable compensation practices.
    $51k-73k yearly est. 2d ago
  • Senior AI-Driven Tech Product Manager (Remote)

    Unitedhealth Group 4.6company rating

    Remote or Boston, MA job

    A leading healthcare organization is seeking a Senior Technical Product Manager to guide initiatives across digital membership. This role involves collaborating with engineering and business teams to drive the execution of complex technical products. The ideal candidate has over 7 years of experience in product management and must possess strong knowledge of LLMs and data product lifecycle. The role offers remote flexibility across the U.S., ensuring innovative and scalable product delivery. #J-18808-Ljbffr
    $82k-99k yearly est. 3d ago
  • UX Intern - Remote USA Position-Ameritas HQ is Lincoln, NE

    Ameritas 4.7company rating

    Remote or Lincoln, NE job

    Back UX Intern #5441 Remote USA Position-Ameritas HQ is Lincoln, Nebraska, United States Apply X Facebook LinkedIn Email Copy Position Locations Remote USA Position-Ameritas HQ is Lincoln, Nebraska, United States Area of Interests Intern Full-Time/Part Time Part-time Job Description Position Description: Ameritas is seeking a User Experience (UX) Intern to enhance our customers' digital experiences by researching user experience across our digital platforms. Position Location: This is a hybrid role (Cincinnati, OH) working partially in-office and partially from home. Position Start Date: This internship will begin in May 2026. What You'll Do: Design intuitive, user-friendly digital experiences that align with project goals and customer needs. Translate complex challenges into clear, user-centered solutions. Conduct and analyze UX research to uncover insights and inform design decisions. Create prototypes and design deliverables that effectively communicate ideas to stakeholders. Collaborate with product owners, developers, and designers to ensure a seamless process from concept to launch. Partner with UI developers to align design intent with implementation. Support ongoing product iteration based on research, user feedback, and performance data. Contribute to design system consistency, accessibility standards, and current UX best practices. Participate in project meetings and advocate for the user perspective in cross-functional discussions. Explore ways to integrate AI tools into the design process (e.g., generating design variations, analyzing feedback, enhancing accessibility). Stay curious about emerging technologies, including AI, and how they can elevate the design process and user experience. What You Bring: Must be enrolled in a Master's degree program at least half-time as defined by your institution studying Human-Computer Interaction, Design, or a related field for the entire duration of the internship. Able to commit to a full-time, 3-month summer internship. Full-time hours: 40 hours per week Prior experience in UX or digital product design (academic, internship, or personal projects). Familiarity with design tools such as Figma and Adobe Creative Suite. Basic understanding of front-end development (HTML, CSS); exposure to AI-assisted design techniques is a plus. Strong attention to detail and ability to translate requirements into interactive solutions. Clear communicator who collaborates well across teams. Awareness of accessibility guidelines, design systems, and web standards. Interest in applying AI tools and data-driven insights to improve design outcomes. Experience with generative AI tools and workflows is a strong advantage. Possess a growth mindset: comfortable with ambiguity, open to feedback, and eager to learn. Ability to manage multiple responsibilities within Agile/Scrum teams. Online portfolio or sample projects showcasing creative thinking and problem-solving skills. What we offer: At Ameritas, our mission is Fulfilling Life. We do that in many ways, but especially by helping people invest in themselves by offering trusted financial products and advice. Because we believe everyone should be happy, healthy, and financially secure, we work hard to provide trusted financial products and valued guidance, including individual life and disability insurance, employee benefits, retirement planning, investments, and wealth management services. Our company motto is "Fulfilling Life" and we take that job seriously, with a heavy commitment to volunteering and community support, employee well-being, and providing quality products and services that help our customers create a brighter future. Being a mutual-based organization, the return on our investment goes back into the company, to benefit our members/customers. We're committed to professional development, opportunity, inclusion, and diversity. Team building and collaboration are also priorities. An Equal Opportunity Employer Ameritas has a reputation as a company that cares, and because everyone should feel safe bringing their authentic, whole self to work, we're committed to an inclusive culture and diverse workplace, enriched by our individual differences. We are an Equal Opportunity/Affirmative Action Employer that hires based on qualifications, positive attitude, and exemplary work ethic, regardless of sex, race, color, national origin, religion, age, disability, veteran status, genetic information, marital status, sexual orientation, gender identity or any other characteristic protected by law. About this Position's Pay The pay range posted reflects a nationwide minimum to maximum covering all potential locations where the position may be filled. The final determination on pay for any position will be based on multiple factors including role, work location, skill set, and candidate level of experience to ensure pay equity within the organization. Job Details Pay Range Pay RangeThe estimated pay range for this job. Disclosing pay information promotes competitive and equitable pay. The actual pay rate will depend on the person's qualifications and experience. $13.33 - $26.67 / hour Pay Transparency Pay transparency is rooted in principles of fairness, equity, and accountability within the workplace. Sharing pay ranges for job postings is one way Ameritas shows our commitment to equitable compensation practices.
    $13.3-26.7 hourly 5d ago
  • Surest Key Account, Account Executive - Remote - California

    Unitedhealth Group 4.6company rating

    Remote or Minnetonka, MN job

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together Surest is transforming the way people experience health benefits by offering a smarter, simpler, and more transparent health plan. We empower individuals to make informed care decisions while helping employers manage costs and improve outcomes. As part of our growing team, you'll play a key role in driving adoption and expanding our impact across markets. The Surest AE is responsible for supporting both reactive and proactive sales efforts across local markets. This role serves as a subject matter expert (SME) on Surest products and capabilities, helping to position Surest effectively in competitive opportunities and drive pipeline growth. The ideal candidate will be a dynamic communicator, strategic thinker, and collaborative partner across internal and external stakeholders. If you are located in California, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: Reactive Sales Activities Represent Surest as a product SME in "Know Us" meetings, finalist presentations, and broker events Deliver compelling product descriptions and demos tailored to client needs Support RFP responses, including plan positioning, pharmacy and clinical capabilities, exception requests, and product options Respond to ad hoc inquiries related to product functionality and search capabilities Assist in gathering client references and presale analytics to support sales efforts Proactive Pipeline Development Drive additional Surest opportunities through strategic outreach and relationship-building Promote and schedule "Know Us" meetings to educate prospects and deepen engagement Leverage Highspot and other marketing tools to support prospecting and lead generation Collaborate with internal teams to identify and pursue new business opportunities You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: 3+ years of experience Proven success in sales, account management, or business development within healthcare or benefits 3+ years Strong presentation and communication skills, with the ability to tailor messaging to diverse audiences 3+ years of experience supporting RFPs and navigating complex sales cycles Proven ability to work cross-functionally with product, clinical, and underwriting teams Proven self-starter with a proactive mindset and strong organizational skills Proven ability to travel 50% in the state of California and neighboring states Preferred Qualification: Familiarity with digital sales enablement platforms (e.g., Highspot) *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,000 to $130,000 annually based on full-time employment. This role is also eligible to receive bonuses based on sales performance. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $60k-130k yearly 5d ago
  • RN Care Coordinator - Remote in Archuleta, La Plata, Dolores and Montezuma Counties, CO preferred

    Unitedhealth Group 4.6company rating

    Remote or Pagosa Springs, CO job

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start **Caring. Connecting. Growing together.** Doing the right thing is a way of life at Rocky Mountain Health Plans (RMHP). As part of the UnitedHealthcare family of plans, RMHP provides innovative health insurance coverage and personalized attention to individuals of all ages and business of all sizes throughout Western and rural Colorado. RMHP is continually striving to improve the health and wellness of our Members and partners in the state where we live, work, and play - because we're Colorado, too. The RN Behavioral Health Clinical Care Coordinator will be the primary care manager for a panel of members with complex medical/behavioral needs. Care coordination activities will focus on supporting member's medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care. If you reside locally to Archuleta, La Plata, Dolores or Montezuma Counties, CO, you will have the flexibility to work remotely* while taking on some tough challenges. **Primary Responsibilities:** + Engage members and/or their families face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs + Develop and implement individualized, person-centered care plans inclusive of goals, opportunities and interventions aligned with a person's readiness to change to support the best health and quality of life outcomes by meeting the member where they are + Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan + Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health + Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission + Advocate for members and families as needed to ensure the member's needs and choices are fully represented and supported by the health care team You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Current, unrestricted independent licensure as a Registered Nurse in Colorado + 2+ years of clinical experience + 1+ years of experience with MS Office, including Word, Excel, and Outlook + Driver's License and access to reliable transportation + Ability to travel up to 25% of the time within SW Colorado (Archuleta, La Plata, Dolores, Montezuma) to meet with members and providers + Resdient of Colorado **Preferred Qualifications:** + BSN, master's degree or higher in clinical field + CCM certification + 1+ years of community case management experience coordinating care for individuals with complex needs + Behavioral health experience + Experience working in team-based care + Background in Managed Care Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
    $28.3-50.5 hourly 4d ago
  • Sr. Tech Prod Manager - Remote - 2311298

    Unitedhealth Group 4.6company rating

    Remote or Boston, MA job

    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find 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. Consumer digital is looking for a senior technical product manager to guide the planning, execution, and successful delivery of initiatives across UHC's entire digital membership. Our digital experiences ensure that members find care at the right place, at the right time, with a full understanding of the impact against their benefits. The Senior Technical Product Manager is a strategic leader responsible for driving the execution of complex technical products. This role bridges the gap between engineering teams and business stakeholders, ensuring products are innovative, scalable, and delivered on time and with quality. You'll enjoy the flexibility to work remotely* from anywhere within the U.S. during XYZ time zone business hours 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: Cross-Functional Leadership: Collaborate closely with engineering, design, and business teams to define high-level solutions, data flows, and architectural decisions. Build strong relationships between stakeholders to remove obstacles and resolve conflicts Backlog & Prioritization: Own and manage the product backlog across iOS, Android, and web platforms, ensuring user stories and tasks are prioritized based on business value, customer needs, and technical feasibility. Tie work items directly to OKRs and business objectives Product Delivery: Lead cross-functional teams through the product development lifecycle, from conception to launch and beyond. Ensure products meet quality standards, acceptance criteria, and deliver measurable outcomes Continuous Improvement: Drive continuous feedback loops to ensure teams remain focused on customer needs. Refine product backlog, participate in release planning, and facilitate agile ceremonies AI-Driven: Lead the development of advanced AI-powered solutions, enhancing how members discover and interact with their healthcare providers. Review prototypes for new AI-powered features and analyze new opportunities within the product against the latest technology trends. Collaborate with UX research to validate the latest AI concepts. Partner with AI and ML teams to develop best in class conversational AI tools You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Bachelor's degree or above Computer Science, Engineering, Business, or a related field 7+ years of experience in technical product management Experience collaborating and leading across multiple partner teams with strong systems thinking Solid knowledge of LLM and data product lifecycle, including discovery, data processing, model development, deployment, and monitoring. Understand how to interact with LLMs through APIs, fine-tune them for specific tasks, and optimize their performance Ability to manage multiple high stakes timelines in a fast-paced environment Preferred Qualifications: Experience with working with global teams Solid technical acumen with the ability to work closely with AI/ML teams and understand model capabilities and limitations *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone‑of every race, gender, sexuality, age, location and income‑deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug‑free workplace. Candidates are required to pass a drug test before beginning employment. #J-18808-Ljbffr
    $89.9k-160.6k yearly 3d ago
  • Medical Director - Post-Acute Care Management - Care Transitions - Remote anywhere in US

    Unitedhealth Group 4.6company rating

    Remote or Phoenix, AZ job

    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.** **Why Care Transitions?** At Care Transitions, our mission is to work with extraordinarily talented people who are committed to making a positive and powerful impact on society by transforming health care. Care Transitions is the result of almost two decades of dedicated visionary leaders and innovative organizations challenging the status quo for care transition solutions. We do health care differently and we are changing health care one patient at a time. Moreover, have a genuine passion and energy to grow within an aggressive and fun environment, using the latest technologies in alignment with the company's technical vision and strategy. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. We are currently looking for Medical Directors that can work daytime in any of the continental time zones in the US. **Primary Responsibilities:** + Provide daily utilization oversight and external communication with network physicians and hospitals + Daily UM reviews - authorizations and denial reviews + Conduct peer to peer conversations for the clinical case reviews, as needed + Conduct provider telephonic review and discussion and share tools, information, and guidelines as they relate to cost-effective healthcare delivery and quality of care + Communicate effectively with network and non-network providers to ensure the successful administering of Care Transitions' services + Respond to clinical inquiries and serve as a non-promotional medical contact point for various healthcare providers + Represent Care Transitions on appropriate external levels identifying, engaging and establishing/maintaining relationships with other thought leaders + Collaborate with Client Services Team to ensure a coordinated approach to delivery system providers + Contribute to the development of action plans and programs to implement strategic initiatives and tactics to address areas of concern and monitor progress toward goals + Interact, communicate, and collaborate with network and community physicians, hospital leaders and other vendors regarding care and services for enrollees + Provide leadership and guidance to maximize cost management through close coordination with all network and provider contracting + Regularly meet with Care Transitions' leadership to review care coordination issues, develop collaborative intervention plans, and share ideas about network management issues + Provide input on local needs for Analytics Team and Client Services Team to better enhance Care Transitions' products and services + Ensure appropriate management/resolution of local queries regarding patient case management either by responding directly or routing these inquiries to the appropriate SME + Participate on the Medical Advisory Board + Providing intermittent, scheduled weekend and evening coverage + Perform other duties and responsibilities as required, assigned, or requested You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Board certification as an MD, DO, MBBS with a current unrestricted license to practice and willing to maintain necessary credentials to retain the position + Current, unrestricted medical license and the ability to obtain licensure in multiple states + 3+ years of post-residency patient care, preferably in inpatient or post-acute setting **Preferred Qualifications:** + Licensure in multiple states + Willing to obtain additional state licenses, with Optum's support + Understanding of population-based medicine, preferably with knowledge of CMS criteria for post-acute care + Demonstrated ability to work within a team environment while completing multiple tasks simultaneously + Demonstrated ability to complete assignments with reasonable oversight, direction, and supervision + Demonstrated ability to positively interact with other clinicians, management, and all levels of medical and non-medical professionals + Demonstrated competence in use of electronic health records as well as associated technology and applications + Proven excellent organizational, analytical, verbal and written communication skills + Proven solid interpersonal skills with ability to communicate and build positive relationships with colleagues + Proven highest level of ethics and integrity + Proven highly motivated, flexible and adaptable to working in a fast-paced, dynamic environment *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Compensation for this specialty generally ranges from $238,000 - $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
    $238k-357.5k yearly 3d ago
  • Provider Relations Advocate - Remote in KS

    Unitedhealth Group 4.6company rating

    Remote or Overland Park, KS job

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. There are changes happening in health care that go beyond the basics we hear in the news. People like you and organizations like UnitedHealth Group are driving ever higher levels of sophistication in how provider networks are formed and operate. The goal is to improve quality of service while exploring new ways to manage costs. Here's where you come in. You'll use your solid customer service orientation and knowledge of insurance claims to serve as an advocate for providers in our networks. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 5 leader. If you are in the State of Kansas or within 50 miles of the border, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: Assist in end-to-end provider claims processing and resolution Assist in efforts to enhance ease of use of physician portal and future services enhancements Assist in identifying gaps in network composition and services to support network contracting and development teams Use pertinent data and facts to identify and solve a range of problems within area of expertise Investigate non-standard requests and problems, with some assistance from others Work exclusively within a specific knowledge area Prioritize and organize own work to meet deadlines Provide explanations and information to others on topics within area of expertise. Use pertinent data and facts to identify and solve a range of problems within area of expertise Investigate non-standard requests and problems, with some assistance from others Work exclusively within a specific knowledge area Provide explanations and information to others on topics within area of expertise. Analyzes and investigates claim issues Responsible for training providers on a variety of topics in both small and large settings You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: 2+ years of experience working with Medical Providers 1+ years of experience with Medicaid Regulations 1+ years of experience in providing training or education 1+ years of medical insurance claims/billing experience Willingness and ability to speak and meet with Providers directly on a variety of topics Demonstrated excellent written and oral communication skills Ability to work independently and remain on task with little to no day to day supervision Demonstrated good organization, planning skills Ability to prioritize and meet deadlines from multi staff members through the department Intermediate level of proficiency in claims processing and issue resolution Exceptional presentation, written and verbal communication skills Intermediate level of proficiency with MS Word, Excel, PowerPoint and Access Driver's license and access to reliable transportation Ability to travel on up to 25% of the time within the State of KS Preferred Qualifications: 2+ years of provider relations and / or provider network experience 2+ years of experience of Medicaid experience 1+ years of KS Medicaid and Kansas Billing requirements Previous experience with CSP Facets Intermediate level knowledge MS Word, Excel, PowerPoint Intermediate level of claims processing and issue resolution *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $28k-38k yearly est. 4d ago
  • Regional Sales Representative - Remote, MN

    Ameritas 4.7company rating

    Remote or Eden Prairie, MN job

    Back Regional Sales Representative #5410 Remote, Minnesota, United States Apply X Facebook LinkedIn Email Copy Position Locations Remote, Minnesota, United States Area of Interests Sales Full-Time/Part Time Full-time Job Description Ameritas is seeking a Regional Sales Representative to join a dynamic and collaborative team. In this role, you will build and maintain strong business relationships with brokers, agents and other insurance professionals to meet or exceed established sales goals, quotas, targets or objectives within your assigned territory. You will focus on selling Dental, Vision and Hearing employee benefit products. This position will focus on covering the state of Minnesota. At Ameritas, our mission is Fulfilling Life. We do that in many ways, but especially by helping people invest in themselves by offering trusted financial products and advice. Because we believe everyone should be happy, healthy, and financially secure, we work hard to provide trusted financial products and valued guidance, including individual life and disability insurance, employee benefits, retirement planning, investments, and wealth management services. Position Location: This position is remote and does not require regular in-office presence. The ideal candidate will be located in Minneapolis and surrounding areas. What you do: Develop and maintain multiple business relationships to meet or exceed established sales goals, quotas, or objectives within your assigned territory. Develop a clear understanding of Ameritas business, our diverse Group products, the complex business relationships within the brokerage community and the clients we service. Support new sales initiatives to increase sales of existing products and/or develop sales of new products. Collaborates with internal stakeholders to ensure the proper processing of all sold products from time of sale to issuance. Identify and procure new customer sales opportunities in partnership with brokers in territory Manage the inforce block of business to build new/integrated sales opportunities with existing clients Build, maintain and enhance strong producer relationships through superior product and services knowledge, territory management practices, and excellent customer service. What you bring: Bachelor's degree or equivalent work experience Ability to learn the insurance/financial services industry, including products and marketing practices Ability to demonstrate a leadership presence with internal and external partners with strong ability to create relationships and be a team player Excellent interpersonal, presentation and collaboration skills. Highly energized, motivated, results oriented self-starter with problem-solving skills. Excellent time management, organization, and project management abilities Ability to work with a team to achieve optimal results. What we offer: A meaningful mission. Great benefits. A vibrant culture Ameritas is an insurance, financial services and employee benefits provider Our purpose is fulfilling life. It means helping all kinds of people, at every age and stage, get more out of life. At Ameritas, you'll find energizing work challenges. Flexible hybrid work options. Time for family and community. But dig deeper. Benefits at Ameritas cover things you expect -- and things you don't: Ameritas Benefits For your money: 401(k) Retirement Plan with company match and quarterly contribution Tuition Reimbursement and Assistance Incentive Program Bonuses Competitive Pay For your time: Flexible Hybrid work Thrive Days - Personal time off Paid time off (PTO) For your health and well-being: Health Benefits: Medical, Dental, Vision Health Savings Account (HSA) with employer contribution Well-being programs with financial rewards Employee assistance program (EAP) For your professional growth: Professional development programs Leadership development programs Employee resource groups StrengthsFinder Program For your community: Matching donations program Paid volunteer time- 8 hours per month For your family: Generous paid maternity leave and paternity leave Fertility, surrogacy and adoption assistance Backup child, elder and pet care support An Equal Opportunity Employer Ameritas has a reputation as a company that cares, and because everyone should feel safe bringing their authentic, whole self to work, we're committed to an inclusive culture and diverse workplace, enriched by our individual differences. We are an Equal Opportunity/Affirmative Action Employer that hires based on qualifications, positive attitude, and exemplary work ethic, regardless of sex, race, color, national origin, religion, age, disability, veteran status, genetic information, marital status, sexual orientation, gender identity or any other characteristic protected by law. About this Position's Pay This is a sales position. The posted range reflects the base pay and variable compensation. The pay range posted reflects a nationwide minimum to maximum covering all potential locations where the position may be filled. The final determination on base pay for any position will be based on multiple factors including role, career level, work location, skill set, and candidate level of experience to ensure pay equity within the organization. This position will be eligible to participate in our comprehensive benefits package (see above for details). This position will be eligible to participate in our variable compensation program with a target defined by the applicable program. Job Details Pay Range Pay RangeThe estimated pay range for this job. Disclosing pay information promotes competitive and equitable pay. The actual pay rate will depend on the person's qualifications and experience. $71,000.00 - $178,000.00 / year Pay Transparency Pay transparency is rooted in principles of fairness, equity, and accountability within the workplace. Sharing pay ranges for job postings is one way Ameritas shows our commitment to equitable compensation practices.
    $58k-71k yearly est. 5d ago
  • CMHC, CCBHC, and Autism Provider Relations Advocate, Remote in KS

    Unitedhealth Group 4.6company rating

    Remote or Overland Park, KS job

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. There are changes happening in health care that go beyond the basics we hear in the news. People like you and organizations like UnitedHealth Group are driving ever higher levels of sophistication in how provider networks are formed and operate. The goal is to improve quality of service while exploring new ways to manage costs. Here's where you come in. You'll use your solid customer service orientation and knowledge of insurance claims to serve as an advocate for CMHC (Community Mental Health Center), CCBHCs (Certified Community Behavioral Health Clinic) and Autism Providers in our networks. As you do, you'll discover the impact you want and the resources, backing and opportunities that you'd expect from a Fortune 5 leader. If you are located in State of Kansas or within 50 miles of the border, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: Assist in end-to-end provider claims processing and resolution Assist in efforts to enhance ease of use of physician portal and future services enhancements Assist in identifying gaps in network composition and services to support network contracting and development teams Use pertinent data and facts to identify and solve a range of problems within area of expertise Investigate non-standard requests and problems, with some assistance from others Work exclusively within a specific knowledge area Prioritize and organize own work to meet deadlines Provide explanations and information to others on topics within area of expertise. Use pertinent data and facts to identify and solve a range of problems within area of expertise Investigate non-standard requests and problems, with some assistance from others Work exclusively within a specific knowledge area Provide explanations and information to others on topics within area of expertise. Analyzes and investigates claim issues Training providers on a variety of topics in both small and large settings You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: 2+ years of experience working with Medical Providers 1+ years of experience with Medicaid Regulations 1+ years of experience in providing training or education 1+ years of medical insurance claims/billing experience Willingness and ability to speak and meet with Providers directly on a variety of topics Intermediate level of proficiency in claims processing and issue resolution Intermediate level of proficiency with MS Word, Excel, PowerPoint and Access Demonstrated excellent written and oral communication skills Demonstrated ability to work independently and remain on task with little to no day to day supervision Demonstrated good organization, planning skills Demonstrated ability to prioritize and meet deadlines from multi staff members through the department Demonstrated exceptional presentation, written and verbal communication skills Ability to travel on up to 25% of the time within the State of KS Driver's License and access to reliable transportation Preferred Qualifications: 2+ years of provider relations and / or provider network experience 2+ years of experience of Medicaid experience 1+ years of KS Medicaid and Kansas Billing requirements Experience with CSP Facets Knowledge of Behavioral Health Billing Intermediate level knowledge MS Word, Excel, PowerPoint Intermediate level of claims processing and issue resolution *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
    $58.8k-105k yearly 4d ago
  • RN Care Coordinator - Remote in Archuleta, La Plata, Dolores and Montezuma Counties, CO preferred

    Unitedhealth Group 4.6company rating

    Remote or Arboles, CO job

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start **Caring. Connecting. Growing together.** Doing the right thing is a way of life at Rocky Mountain Health Plans (RMHP). As part of the UnitedHealthcare family of plans, RMHP provides innovative health insurance coverage and personalized attention to individuals of all ages and business of all sizes throughout Western and rural Colorado. RMHP is continually striving to improve the health and wellness of our Members and partners in the state where we live, work, and play - because we're Colorado, too. The RN Behavioral Health Clinical Care Coordinator will be the primary care manager for a panel of members with complex medical/behavioral needs. Care coordination activities will focus on supporting member's medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care. If you reside locally to Archuleta, La Plata, Dolores or Montezuma Counties, CO, you will have the flexibility to work remotely* while taking on some tough challenges. **Primary Responsibilities:** + Engage members and/or their families face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs + Develop and implement individualized, person-centered care plans inclusive of goals, opportunities and interventions aligned with a person's readiness to change to support the best health and quality of life outcomes by meeting the member where they are + Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan + Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health + Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission + Advocate for members and families as needed to ensure the member's needs and choices are fully represented and supported by the health care team You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Current, unrestricted independent licensure as a Registered Nurse in Colorado + 2+ years of clinical experience + 1+ years of experience with MS Office, including Word, Excel, and Outlook + Driver's License and access to reliable transportation + Ability to travel up to 25% of the time within SW Colorado (Archuleta, La Plata, Dolores, Montezuma) to meet with members and providers + Resdient of Colorado **Preferred Qualifications:** + BSN, master's degree or higher in clinical field + CCM certification + 1+ years of community case management experience coordinating care for individuals with complex needs + Behavioral health experience + Experience working in team-based care + Background in Managed Care Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
    $28.3-50.5 hourly 4d ago

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