Perform utilization review determinations for radiation oncology populations, and support case and disease management teams to achieve optimal clinical outcomes Speak with providers by phone. This will include discussion of evidence based guidelines, opportunities to close clinical quality / service gaps, and care plan changes that can impact health care expense Enhance c

Investigate medium to highly 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 information in the Special Investigations Unit's (SIU's) case tr

Focus on initial and concurrent reviews for higher levels of care Inpatient admission for psychiatric and chemical dependency patients via telephone Make patient assessments and determine appropriate levels of care Obtain information from providers on outpatient requests for treatment. Facility Based Care Advocates only work with providers for outpatient request prior to

Oversee initial inpatient admission requests for psychiatric and chemical dependency patients Make patient assessments and determine appropriate levels of care Administer benefits, review treatment plans, and coordinate transitions between various areas of care Obtain information from providers on outpatient requests for treatment Provide utilization management concurrent

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Conne

Responsible for researching and resolving payroll tax issues Act as an SME for payroll tax questions and issues, troubleshoot when needed Partner with HR Operations to manage escalated cases related to payroll taxes, including communication directly to employees based on their individual situation, as well as outside tax vendors/organizations Responsible for running queri

Develop and maintain strong broker/consultant relationships Develop and maintain key internal relationships Understand customer and broker/consultant needs and provide value added consultation Identify key brokers/consultants for management development Understand goals, operating principles, strategies and competitive position of specialty benefits portfolio In depth Spec

Responsible for managing a team of Field Account Managers based throughout the State of Nevada Management and triage of customer related contacts, wellness integration and assistance in supporting UHG value proposition Training and development of employees, leading and developing a team of employees Managing employees up into other opportunities within the organization Ma

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connect

Answer incoming phone calls from prospective members, identify the type of assistance and information the customer needs with the goal to convert caller to a qualified lead and sale Follow up with members on questions or to review current or new products and services Navigate multiple computer systems to document member information while maintaining active listening and e

Growth Define, develop and implement a data driven, locally focused membership growth strategy for the DC health plan. This includes areas/skills such as Strategic thinking and planning, including project management Market research and analysis Sponsorship and budget planning and management Collaboration with national and health plan teams Community Engagement Thoughtfull

Telecommute Behavioral Health Advocate/Sign-On Bonus/Fortune 5 Organization!

Telecommute Position! Sign-On Bonus! Great Opportunity! Fortune 5 Organization!

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connect

Ability to manage elements of a health plan compliance program with an understanding of state based government health care programs and products Engage in complex remediation strategy & resolution and promote compliance with applicable laws and contractual obligations for various Medicaid products Ability to flex by working across different markets with varying needs and