Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e., benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs) Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems Own problem

Make outbound calls and receive inbound calls to assess members' current health status Identify gaps or barriers in treatment plans Provide patient education to assist with self management Make referrals to outside sources Provide a complete continuum of quality care through close communication with members via in person or on phone interaction Support members with condit

Provide quality reporting and analytics to support the end to end Super Hero program Partner with the program director to determine the nomination and selection strategy and gain key stakeholder support. Identify process improvements and develop solutions to streamline and scale the nomination and selection process Lead the nomination and selection process including Devel

Manage overall delivery of benefits and services by providing support and guidance to existing and potential customers to ensure continued membership Provide expertise and customer service support to members, customers, and / or providers Identify and resolves operational problems using defined processes, expertise, and judgment Investigate claim and / or customer service

Serve as a coding resource and provide coding expertise and guidance for IFP Product and configuration partners Develop and maintain code sets used to define IFP medical and specialty benefits (hearing, vision, dental), seeking and promoting enterprise alignment when appropriate In partnership with Product and Clinical partners, ensure IFP sources of truth for benefit adm

Investigations Refine investigation protocols, documentation standards, and policy interpretation guidelines in partnership with Employment Law and ER Case Management leadership Conduct thorough, timely, objective, efficient and equitable investigations into employee complaints and allegations of misconduct, in line with agreed upon investigation framework and applicable

Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, least 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 Com

Assess, plan, and implement care strategies that are individualized by member and directed toward the most appropriate care Utilize both company and community based resources to establish a safe and effective case management plan for members Collaborate with member, family, and healthcare providers Identify and initiate referrals for social service programs, including fin

Accountable for customer (employer) loyalty and satisfaction, as measured by survey results and persistency Establish, cultivate and manage the customer relationship at multiple levels, serving as a healthcare consultant and trusted business advisor to these customers Establish, cultivate and manage relationships with consultants and brokers, recognizing the value they br

Provide office and community based resource coordination and member education to help improve member wellness and quality of life Provide Housing Supports and Services as defined in state contract to eligible members experiencing housing insecurity Collaborate with internal teams and community organizations to support members through housing related needs Assist members i

Successfully develop, define, and implement a prospecting strategy and sales approach for assigned targets that delivers desired sales outcomes, working directly with prospective employer clients Achieve new business sales membership goals on an annual basis Develop trusted relationships with a targeted set of prospective clients in the National Accounts space. These pros

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 and start doing

Develop key internal and external relationships to facilitate results. Understand and create a strategy based on analysis and reporting of sales and market trends, including sales plan execution, competitive intelligence and new product requirements Drive the development of market sales strategies and value proposition formulation Lead as an expert in our national account

Provide primary care, including ordering and evaluating diagnostic/screening/laboratory tests, and management of minor acute illnesses Conduct comprehensive wellness assessments on members either in the clinic or patients' home as needed Assess diagnose and manage chronic conditions for patient population Identify deviations from normal, initiates and evaluates treatment

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