Assist physicians and nursing personnel with injections, EKGs, phlebotomy and other patient care procedures Maintain established quality control standards Record and process patient care documentation quickly and accurately Coordinate patient care as directed by physicians, company standards and policies Organize, stock and clean exam and treatment rooms and sterilize instruments Maintains qu

Answer 50 70 incoming phone calls per day from customers and identify the type of assistance the customer needs Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems Contact care providers (doctor’s offices) on behalf of the customer to assist with appointment scheduling or connections with internal s

Collaborate with product management and cross capability engineering teams to analyze user needs and business requirements Responsible for the design and implementation of data adapters from proprietary interfaces to FHIR R4 Collaborate with other team members, participating in architecture discussions and team code reviews Design, develop, code, test, and debug complex software products and make

Appeals and Grievances Medical Director – Virtual – Alternate Schedule Work at home! The Appeals and Grievances Medical Director is responsible for ongoing clinical review and adjudication of appeals and grievances cases for UnitedHealthcare associated companies. Performance accountabilities include Perform individual case review for appeals and grievances for various health plan and i

Work with National Response Team leaders to design, develop and implement new strategies, products and services Develop and maintain the clinical quality structure, operational capability cadence and work environment to effectively support National Response Team strategic and implementation plans and delivery Develop medical and clinical operations program goals Develop, review, and communicate po

Use pertinent data and facts to identify and solve a range of problems within area of expertise Investigate non standard requests and problems, with some assistance from others Work exclusively within a specific knowledge area Prioritize and organize own work to meet deadlines Provide explanations and information to others on topics within area of expertise Design and complete data analysis projec

Develop a professional relationship with member physician office, and managed care payer personnel. Educate providers on client’s processes for treatment review. Coordinate selected registration, scheduling, faxing, billing and reporting for OrthoNet contracts may include, maintaining logs, faxing, verifying information, entering data, generating reports, etc. Research appropriate benefit do

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 Communicate with all stake

Ability to manage a compliance program with an understanding of complex or dual products Engages in high risk/complex remediation strategy & resolution and promote compliance with applicable laws and contractual obligations for various Medicaid products Collaborate with a team that conducts product specific legal research and monitors changes to requirements to mitigate risks and achieve compl

Manage the entire client onboarding project for implementation, act as the main contact for the client Conduct client benefit discussions with all parties and ensure client sign off for their benefit intent forms Coordinate efforts with internal departments for the creation of formulary, specialty products and pharmacy networks Coordinate formulary / specialty disruption analysis to impacted me

If you want to achieve more in your mission of health care, you have to be really smart about the business of health care. Challenge yourself, your peers and our industry by shaping what health care looks like and doing your life's best work.(sm) Clinical Performance is charged with effectively implementing, monitoring, and executing on programs related to driving affordability, clinical quality a

No industry is moving faster than health care. And no organization is better positioned to lead health care forward. We need attention to every detail with an eye for the points no one has considered. The rewards for performance are significant. You'll help improve the health of millions. And you'll do your life's best work.(sm) As a Manager, Risk Adjustment you'll provide consulting services to s

Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doin your life's best work. Positions in this function includes managing incoming calls, managing requests for services from members, providing information on avai

Assess, screen, triage and perform treatment ordered for patients Perform medical treatment as ordered by provider or established MedExpress standing orders Prepare and assist provider with dispensing prescribed medications (in states where applicable) Assists the provider with examinations, procedures and other duties Oversee and coordinate the daily patient care flow Assist patients as neede

No industry is moving faster than health care. And no organization is better positioned to lead health care forward. We need attention to every detail with an eye for the points no one has considered. The rewards for performance are significant. You'll help improve the health of millions. And you'll do your life's best work.(sm) The VP of Advisory Services/Technology Services will be focused on de