Lead development and documentation of an integrated Medical Management Program solution to meet the Statement of Work (SOW) requirements, contributing to the RFP for the TRICARE contract. Guide a team of subject matters experts for population health, Case Management, Clinical Quality and Utilization Management to develop components of the overall Medical Management solution model of delivery and d

Establish and maintain positive clinical rapport with patients and their families, working closely with them in the provision of infusion therapy, education related to self care and self administration, and clinical monitoring of patient response to therapy Assess patient appropriateness for home infusion therapy, including safety of the home environment, availability of caregiver support, and wil

Make phone calls to current and prospective Medicare population Comply with regulatory and company policies for marketing materials and communications Implement and coordinate new growth strategies Keep informed of new or modified business strategies and act quickly to operationalize Support Medicare products Drive Medicare product sales Develop strategies and tactical plans to support consumer/me

Manage and lead new Health Plan (all sizes)implementation, includingCommercial, Medicaid, Medicare, and Exchange lines of business Develop detailed work plans, schedule estimates, resource plans, status reports, and implementation priorities Direct and coordinate the teams of operations, business, product and technical contributors to ensure the on time, within budget, successful delivery of pro

Manage project planning and execution for team's multiple value based projects Set direction, resolve problems and provide guidance to team members Adapt project plans and priorities to address business and operational challenges Influence and provide input to planning activities for team's value based projects Create reports as needed for management Facilitate communications between team, network

Provide preventative and primary care for patients in assigned long term care facilities Work with primary care physicians to provide the best care possible Collaborate with the nursing staff and the patients' families Work with the facility's utilization review process In this role, you'll also explore and learn more about palliative care You'll be rewarded and recognized for your performance in

Support SAFe DevSecOps process and methodology in a large federal IT program Design, set up, monitor, and enhance a Continuous Delivery pipeline\ Build infrastructure as code in an AWS environment Support and work closely with both engineers & stakeholders You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes

Builds in depth analysis of Operational outcomes Creates recommendations for the business/operation based on leading indicators and true operational outcomes Leads large/complex projects & analysis to achieve business objectives, asks, and needs Investigates unique and complex problems with broad impact on the business Translates/shows data in highly complex concepts that can be understood by a va

Manage all aspects of defensive litigation and arbitrations involving the company; provide legal advice on complex and sensitive matters regarding various laws applicable to health care; may provide legal counsel in connection with internal investigations, subpoenas, and responses to government inquiries Acquire and leverage deep knowledge of the industry and the specific business practices of the

In collaboration with scientific leadership, oversee and implement internally and externally funded research studies and projects Implement research studies develop and maintain project timelines, oversee development of study materials and procedures, maintain study documentation and manage records, oversee study recruitment and data collection, develop and implement data quality procedures, plan

Support process to measure and track OptumRx client rate concessions given most renewal cycles Develop close partnership with Account Management and Pricing to create a repeatable process for measurement of various client financial metrics including discount rates Perform client profitability financial analysis, identify trends, and make recommendations for improvement in overall financial results

Develop, document, and plan for delivery of a UM Program supporting an integrated model of MM delivery to meet TRICARE RFP requirements for the MM Program Establish UM team organizational structure, work assignment and work cadence to meet timelines for interim and final deliverables to Program Management for inclusion in the MM Solution for the OptumServe proposal for the TRICARE RFP Provide UM s

Provides skilled nursing services that require substantial and specialized nursing care including medication administration, wound care, wound vacs, IV administration including PICC and peripheral lines, therapeutic treatments, and skilled teaching as ordered and indicated Plans and implements patient health teaching and health counseling regarding the disease process(es), self care techniques and

Greet & check inpatients as they enter the practice. This will include checking temperate, providing mask and hand sanitizer Assist Medical Receptionist as needed with potential to complete the following Schedule and triage appointment requests for urgency according to approved protocols consistent with ProHealth's Appointment and Scheduling Guidelines. Consult a medical assistant or licensed clin

Analyze and report on financials Assist in the development of program forecasts, budgets, and plans Research economic progressions to assist with the organization's financial planning Create annual budget templates Prepare spreadsheets to effectively show financial results and financial forecasts You'll be rewarded and recognized for your performance in an environment that will challenge you and g