136 to 150 of 246
Understand and explain drivers of apparent quality trends (observation bias, metric changes, operational changes, industry trends) Initiate and foster unique and innovative solutions and ideas Bring disparate data together with knowledge of health care and government policy to develop and communicate sound business recommendations to leaders throughout the organization Qu
Posted 8 days ago
Respond to and resolve, on the first call, customer service inquires and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims, financial spending accounts and correspondence Help guide and educate customers about the fundamentals and benefits of consumer driven health care topics to select the best benefit plan o
Posted 8 days ago
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 Co
Posted 8 days ago
Work with Community Based Organizations that provide services, resources and education for Medicaid members Participate in local and statewide Health Council meetings, community meetings and school based community events Communicate requests, opportunities for collaboration and CBO meetings that Health Plan can participate Engage Health Plan resource staff clinical staff,
Posted 8 days ago
Telecommute Healthcare Advocate
Posted 8 days ago
UnitedHealth Group
- East St. Louis, IL / Fenton, MO / St. Louis, MO
Telecommute CDI Specialist (St. Louis, MO)
Posted 8 days ago
Serve as primary care manager for elderly and/or disabled members who live in individual housing, community based housing (ALF or CLS homes) or nursing facilities Engage members and/or their families face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) n
Posted 9 days ago
Travel, assess, create plans of care Authorize LTSS services within prescribed timeframes The direct and day to day management of our LTSS members in Davidson County area 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 succeed in your role as well as provide development for o
Posted 9 days ago
Perform initial and concurrent review of inpatient cases applying evidenced based criteria (InterQual criteria) Discuss cases with facility healthcare professionals to obtain plans of care Collaborate with Optum Enterprise Clinical Services Medical Directors on performing utilization management Participation in discussions with the Clinical Services team to improve the pr
Posted 9 days ago
Identify and provide community service linkage Assist enrollees with aftercare appointments Provide subsequent member follow up as determined by individual member needs Work with enrollees to identify gaps in care or obstacles to care and problem solve for successful connection to needed services Review IP Census each day to determine which enrollees on the census are re
Posted 9 days ago
Engage members, family, and caregivers face to face to complete a comprehensive health needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Develop and implement person centered Health Action Plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants o
Posted 9 days ago
Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medicati
Posted 9 days ago
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, c
Posted 9 days ago
Day to day management and administration of behavioral health benefits for facility based care Utilize clinical assessments to determining appropriate levels of care Evaluate additional clinical services are needed Effectively coordinate benefits and transitions between various levels of care Identify ways to add value to treatment plans and consult with facility staff to
Posted 9 days ago
improving the quality, cost, and experience of health care. Here, we focus on delivering the best patient care, rather than volume. Through innovation and superior care management, we support patients and your well being as a team member. Join a team at the forefront of value based care and discover the meaning behind. The Nursing Internship Program is full time, 40 hours
Posted 9 days ago
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