Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, at least restrictive level of care Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact

Educate members on health education and condition management (formal and informal), as well as plan specifics and member resources, in collaboration with OptumHealth Referral of employees to available clinical programs including premium designated physicians Create, manage, and implement employer specific programs based on employer needs Monitors and analyzes customer spe

Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Co

As part of a multi disciplinary care coordination team Addresses the total patient, inclusive of medical, psychosocial, behavioral, cultural, and spiritual needs Involves the individual patient and caregiver, as appropriate, in decision making Facilitates communication and coordination among members of the care team Provides patient care to include patient assessment prio

Make calls to qualified members to provide information and answer questions about health plan programs. Provide "best in class" customer service to enrollees Meet established productivity, schedule adherence, and quality standards while maintaining good attendance. Identify, qualify, and engage members into the most appropriate health and wellness programs to meet their n

Responsible for handling inbound calls, from providers and members in a call center environment Conduct initial clinical assessments and determine appropriate levels of care, based on medical necessity Explain and administer benefits according to plan descriptions for all levels of care (OP, IOP,PHP,RTC,IP) Ability to quickly assess and meet time sensitive deadlines withi

Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals are in response to adverse determinations for medical services related to benefit design and coverage and the application of clinical criteria of medical policies Perform Department of Insurance/Department of

Intake/screening/referral, assessment/reassessment, development of support plans, on going case management, monitoring of the Member's health and welfare, documentation of contacts and case management activities in the Department prescribed system, resource development, and case closure Respect confidentiality and maintain confidences as described in the UHG Employee Hand

Key Agent/Agency Performance Agent Development Mentor, coach and engage key agents/agencies through ongoing business and strategy planning. This includes identifying sales opportunities, product positioning, UHC tools, UHC value proposition, compliance, and market education Onboarding Reach out to new agents identified by the PHD to share UHC learning, growth tools and va

Provide legal and strategic advice on all aspects of real estate matters to the UnitedHealth Group Real Estate Services team Draft, review, and negotiate various commercial real estate agreements including leases and related documents (e.g., letters of intent, subleases, intercompany leases, estoppels, landlord consents, amendments, assignments, etc.), constructions agree

Perform utilization management, utilization review, or concurrent review of behavioral health and substance abuse admissions and continued stays Ensure that behavioral health care services provided are medically necessary per standard guidelines Ensure that behavioral health care services are provided in the most appropriate setting Integrate a collaborative process which

Provide support and strategic counsel on a wide variety of matters including, regulatory compliance and oversight, contracts, STARs, the Inflation Reduction Act, and finance Collaborate with colleagues across the legal, compliance, and regulatory affairs departments You'll be rewarded and recognized for your performance in an environment that will challenge you and give y

Engage directly with care providers, physicians, and office staff via phone calls and faxes Document provider feedback and consult with senior clinical pharmacists if there are questions about treatment, drug efficacy, or authorization status Shadow UHC pharmacists to gain a better understanding of the various roles they have within the UHCP team Collaborate with analytic

Territory will include priority markets in the Central and West Regions with a focus on MN, IL, TX, AZ, CO, and CA Sales VP qualify top prospect utilizing EDGE sales methodology; identifying/creating compelling events that position UHC for success Individual will be an expert at consultative selling with a demonstrated track record of leveraging UHG capabilities to solve

Assess, plan, and implement care strategies that are individualized by member and directed toward the most appropriate, lease restrictive level of care. Identify and initiate referrals for member transition to community request and provide assist with social service programs, including financial, psychosocial, community and state supportive services. Manage the care plan