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, c

Recruits, hires, and manages performance of staff (2 3 employees) providing ongoing feedback, conducting regularly scheduled 1 1s and facilitating the performance management process in a timely manner Leads team pipeline generation, using a curated set of UHG sales tools and prospecting persistence to identify and validate opportunities Guides team members to attain month

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. Connect

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 Provider Services, Private Duty Nursing, DME, and supplies Assist members with the transition from a care facility back to their home This role involve

Utilize the Preferred One medical criteria and those of other regulatory bodies, (i.e. NCQA, DOH), the exempt and focused review programs, and the patient's benefit plan summary to perform medical necessity, level of service and appropriateness review Perform inpatient and outpatient pre admission, concurrent review and decision support based on medical necessity, appropr

Identify potential health care business customers Develop business relationships with agents and/or brokers in order to increase sales Promote sales of health care products to small and medium sized businesses (51 300 employees) customers, through brokers. This includes educating and keeping brokers up to date on products and pricing; evaluating and discussing with broker

Determine that the case is assigned to the appropriate team for review (e.g., Medicare, Medicaid, Commercial) Validate that cases/requests for services require additional research Identify and utilize appropriate resources to conduct non clinical research (e.g., benefit documents, evidence of coverage, state/federal mandates, online resources) Prioritize cases based on ap

Receive assigned medical charts to code Review medical charts electronically Abstract and code diagnosis and documentation information Document requested information from the medical record Perform ongoing analysis of medical record charts for the appropriate coding compliance The key challenge of this role centers around your ability to work quickly, accurately and indep

Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, 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 Co

of Job To effectively and promptly Perform the Administration, build, and troubleshooting for Anaplan models within UHC Workforce Planning & Management, including bugs and enhancements, both in the backend and on the front end (UX) Support multiple different Anaplan models and use cases Understand the differences and similarities between models and assist cross functional

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, c

Work with CICD frameworks to develop data solutions to support performing analysis, interpreting results, creating actionable insights, and presenting recommendations for use across the company Use business intelligence, data visualization, query, analytic and statistical software to build solutions, perform analysis and interpret data Partnering with stakeholders to unde

Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, 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 Co

Work to improve quality and promote evidence based medicine Provide information on quality and efficiency to doctors, patients and customers to inform care choices and drive improvement Support initiatives that enhance quality throughout our national network Ensure the right service is provided at the right time for each member Work with medical director teams focusing on

Contribute and oversee strategic projects, ETL design and architecture, performance tuning activities, Code Reviews, and Best Practices Responsible for approving and certifying the architecture and design of the data warehouse, data marts and BI reports which will support various data initiatives Supervision of development of ETL code with our current toolset, Informatica