UnitedHealthcare is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm) The Manager, Provider Services serves as both a staff leader

Manage a task queue, triaging tasks and routing them to an appropriate assignment group or resource. Conduct analysis and maintain documentation on existing Access Request Process and make improvement recommendations. Process Access requests tasks Assist in testing processes and activities. Assist business users in creating Access Request groups and access to data Develop and maintain a solid unde

Prepare examination rooms and sterilizing equipment Room patients, obtain health history, check vital signs and perform EKG's Administer injections and collect specimens Document patient care using NextGen electronic medical record software Schedule appointments, complete prior authorizations, process medication refills, handle referrals, answer calls and complete paperwork Assist physicians and n

Take inbound calls from providers in a call center environment Work with hospitals, clinics, facilities and the clinical team to manage request for services from members and / or providers Manage the referrals process, processing incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles Provide appropriate triage and care coordination notification c

Develop Java microservices adopting Agile methodologies and DevOps strategies Building REST APIs Integrate the web application with NoSQL databases leveraging the existing Kafka platform Design, develop and conduct functional and performance tests 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 to succee

Conducts concurrent reviews of selected patient records to address clarity, completeness, consistency, and precision of clinical documentation Demonstrates understanding of clinical documentation requirements to ensure that the severity of illness, risk of mortality, and services provided are accurately reflected in the record Serves as a resource on appropriate clinical documentation to support t

Support program/Claims initiatives under the Value based Risk Management program Support the Capability Managers and Product Owners to assist in the documentation of user stories, sprint planning and UAT testing planning, documentation and execution. Coordinate with SMEs to address issues or concerns with the outcomes of the UAT test scenarios and other issues or concerns Facilitate meetings as ap

Contact a call list of patients who are out of compliance for chronic conditions and wellness visits Track all booked and arrived appointments for patients generated through outreach efforts Ensure patient confidentiality with the handling of all patient health information and records Communicate all progress and issues with manager Inbound/Outbound patient phone calls Schedule patient appointment

The Medical Coding Analyst validates progress notes and enters the appropriate ICD 9/ICD 10 coding into the DataRAP database utilizing the Centers for Medicare and Medicaid Services (CMS) Risk Adjustment Data Validation (RADV) guidelines. This position is also responsible for timely communication of identified quality issues concerning documentation and validation pertaining to the CMS HCC methodo

Distribute drugs prescribed by physicians and other health practitioners. Provide information to customers about medications and their use. Strong focus on providing a superior level of customer service. Log data into the computer. Ensure compliance with all relevant laws of the applicable State Board of Pharmacy. Administration of immunizations as allowed by state boards of pharmacy. Any other

Develop territory sales plan Research and identify sales targets Use consultative sales process, probe for customer information and barriers Develop creative solutions to gain profitable business Creates relationships with manufacturers Close sales Serve needs of medical practice accounts and solve issues Manage territory T&E and customer related expenses You'll be rewarded and recognized for you

Consolidate budget, forecasting, and monthly reporting from 20+ unique businesses and geographies Support leadership via a comprehensive monthly reporting package, quarterly business review and earnings release support, and ad hoc reporting Provide visibility, support decision making, and help drive results to maximize resources and create efficiencies Advance data integrity through reconciliatio

If you want to achieve more in your mission of healthcare, you have to be really smart about the business of healthcare. Challenge yourself, your peers and our industry by shaping what healthcare looks like and doing your life's best work.(sm) Reporting to the Region CEO of UnitedHealthcare, the Health Plan CEO will have P&L accountability for all commercial products and distribution in the Market

Travel up to 100% Conduct in home assessments on health plan members Identify diagnoses to be used in care management and active medical management Formulate a list of current and past medical conditions using clinical knowledge, judgment and current findings Communicate gaps in care to member's PCP Identify referral needs Identify urgent and emergent situations for proper intervention Educ

Develop, perform and manage the analyses of business and financial metrics as well as performance measures Develop and maintain financial reports to clearly communicate actual results, forecasted performance; and variances to plan, forecast and budget Work closely with the business to develop, recommend and establish strategies, plans and processes to improve profitability and cost efficiencies Y