Lead, develop and motivate team of in house design experts and third party providers to deliver quality solutions for our office, medical and pharmaceutical locations across the domestic UHG portfolio Demonstrate thought leadership in designing employee, patient, and provider experiences, while maintaining fiscal responsibility Collaborate closely with the Real Estate Cen

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

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

A successful GA Growth Manager will need to strategically and methodically manage a large list of General Agencies to educate, train, and support GA partners to drive new business growth and persistency in partnership with the SBS AE and RAE. This role will be performed remotely and is not a telemarketing position. This role will require a tactical and motivated sales pro

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

Assess complaints of alleged misconduct received within the Company Investigate low to medium complex cases of fraud, waste and abuse Detect fraudulent activity by members, providers, employees and other parties against the Company Develop and deploy the most effective and efficient investigative strategy for each investigation Maintain accurate, current and thorough case

Manages and evaluates direct reports of UM Prior Authorization Nurses, Inpatient Care Managers, Clinical Coordinators, and other team associates Manages the compliance for UM to meet established performance metrics Oversees inventory and ensures cases completed within regulatory timeframes Manages all aspects of the UM program and service timeframes Actively participates

Assisting in the development of the plan of care in addition to providing appropriate patient/ family/significant other counseling and education Ordering and interpreting appropriate laboratory and diagnostic studies Ordering of appropriate medication and treatments Referring patients for consultation when indicated i.e. dermatology, neurology, ophthalmology, endocrine, s

Assist with care management for high medical risks / needs members with comorbid behavioral health needs As a Care Coordinator Assess members 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

Assist with care management for high medical risks / needs members with comorbid behavioral health needs As a Care Coordinator Assess members 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

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

Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care Utilize the NYS UAS Assessment as needed in the home or via telehealth to develop a person center service plan to meet the member's needs Identify and initiate referrals for social service programs, including financial, p

Collaborate with internal partners, such as Environmental and Enterprise Occupational Health and Safety, Accessibility COE, Real Estate Services, Talent Acquisition and Employment Law to assess appropriate accommodation solutions throughout the interactive process Navigate complex leave issues in partnership with the company's disability vendors, Workers Compensation, Pay

Telecommute Healthcare Advocate

Telecommute CDI Specialist (St. Louis, MO)