Create/Own Demand forecasts using statistical models and probabilities to achieve financial and service objectives for multiple lines of business (E&I Member, Government Operations, and Provider) and the business plans (120 414) and their corresponding FTE counts (3500 13,000) including oversight and direction provided to the vendor demand planners Collaborate with Operat

Coordinate and implement patient intake and patient care logistics Answer all incoming phone calls and be able to direct callers to appropriate staff or able to complete caller requests Place outbound calls to patients for scheduling appointments and consultations Identify and assess patient needs seamlessly to achieve customer satisfaction Provide accurate, valid, and co

Assess, plan and implement care strategies that are individualized and directed toward the most appropriate level of care for Medicare and Medicaid members while proactively engaging the member to manage their own health and healthcare Utilize strong skill sets of managing multiple tasks at a time, being self motivated, driven toward quality results, managing time well, b

Evaluates new and on going claims to determine liability, giving consideration to contract provisions, disability management duration contract guidelines, medical evidence and vocational evidence. Investigates questionable claims. Determines need for additional medical information. Performs periodic follow ups to verify continued existence of a disabling condition. Respon

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

Utilize advanced clinical skills to engage and motivate Consumers via a recovery, health and wellness oriented approach Assist consumers and their families/caregivers with connections to appropriate psychiatric, medical, and psychosocial referrals and services Identify and remove barriers to procurement, delivery, participation in and success of services Provide supportiv

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 internal and external sources as outlined by member's benefit plan design Provide a complete continuum of quality care through close communication with members via on

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 condit

Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medicati

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 Com

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. Conne

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

Responsible for managing a team of Field Account Managers based throughout the State of Nevada Management and triage of customer related contacts, wellness integration and assistance in supporting UHG value proposition Training and development of employees, leading and developing a team of employees Managing employees up into other opportunities within the organization Ma

The KA Field Account Manager is accountable for client and member education as well as escalated service issues of small to mid size, standard/non standard customers. In this position, the KA Field Account Manager is responsible for the following Coordinates, staffs, and conducts open enrollment meetings, wellness fairs and lunch and learns Acts as a strategic partner and

You will work closely with the executive leadership team of these groups as a trusted advisor to help maintain a high performing culture by driving strategic and proactive talent acquisition, development and reward programs that are closely aligned to the overall business and people strategy. Proactively provide advice, guidance, and leadership to executives on organizati