Telecommute position/Fortune 5/Excellent Benefits!

Apply knowledges / skills to activities that often vary from day to day Demonstrate a moderate level of knowledge and skills in own function Make outbound calls to members who are eligible to participate in one of our Health Management coaching programs Receive inbound calls to enroll members & / or provide customer service Require little assistance with standard and non

Organize and manage incoming claims Work through a queue with other team members to identify claim needs Identify billing discrepancies Determine member insurance coverage and eligibility status Ensure compliance with federal and state laws and regulations Sort and organize appeals to identify eligibility needs Communicate with legal teams on appeal status Make offers to

Address any escalated issues sent to them, the SAE, or other field employee Work with the central team and their manager to coordinate resolution Meet with customers quarterly (or more often if requested) to review service related statistics including ideas for improving or enhancing the customer's total service experience Conduct training/education with customers on UHC

Engage members either face to face or over the phone to have a discussion about their health Review available member service records and relevant documentation (e.g., utilization history, functional level, stratification information, current plan of care) Conduct comprehensive member assessment that includes bio psychosocial, functional, and behavioral health needs Utiliz

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

Business Growth by achieving assigned sales/membership growth targets in his/her territory/territories. Sales targets are achieved by building and managing agents and agencies within two sales channels 1) Direct Agents who are independent sales agents who contract directly with UnitedHealthcare to sell Individual and Family plans and 2) Field Marketing Organizations (FMO)

Manage and monitor client assignments as well as train the account management staff, new hires and ongoing Set team strategy to achieve and surpass goals, and consistently develop and manage a team of Strategic Account Executives and Field Account Managers Relationship Building Build and maintain key client and producer relationships Develop and maintain key internal rela

Management Manage and monitor client assignments Training of field account management staff, new hire and ongoing Maintain an acceptable level of persistency in teams book of business Personnel development and management Set teams strategy to achieve goals Direct and manage service plan Relationship Building Build and maintain key client and producer relationships Develop

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

Manage the installation of assigned accounts and direct structure building and billing set up Oversee overall employer contract loading using various databases and/or source documents Research installation issues and develop customers specific solutions Audit contract loads for adherence to quality measures and reporting standards Manage and be accountable for employees a

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 prior to physician's/nurse practitioner's examination, serv

Contribute to strategic projects, ETL design and architecture, performance tuning activities, etc Responsible for supporting the architecture and design of the data warehouse, data marts and BI reports which will support various data initiatives Development of ETL code with our current toolset, Informatica, PL/SQL, Snowflake Stored Procedures, Azure Data Factory Perform a

Collaborates with the University Bursar, Registrar, IT Services and Web Services departments to ensure smooth processes throughout the insurance plan year. Coordinates the administrative aspects of a competitive bid process for USHIP and the optional insurance plans. Maintains the University Student Health Insurance Administration Tool, which tracks students' annual enrol

Manage and monitor client assignments Training of account management staff, new hire and ongoing Maintain an acceptable level of persistency in teams book of business Recruit, hire and monitor account management staff Personnel development and management Set account management strategy to achieve goals Direct and manage service plans Build and maintain key client and prod