This position is external facing and requires travel to customer/broker sites. This role supports complex employer groups within the Milwaukee, WI market Extensive analysis and interpretation of complex healthplan performance analytics from multiple data sources. Synthesize complex datasets to understand risk and opportunity of proposed/implemented solutions in support of

Perform individual case review for appeals and grievances for various health plan and insurance products, which may include PPO, ASO, HMO, MAPD, and PDP. The appeals are in response to adverse determinations for medical services related to benefit design and coverage and the application of clinical criteria of medical policies Perform Department of Insurance/Department of

Develop Others into a successful team aimed at increasing growth and market permeation by Continually building and nurturing agents through educational support on product information, selling skills, systems, and processes at United Healthcare Actively engage in the management and coaching of agent performance by implementing successful start strategy and guiding agents t

Identify potential health care business customers Develop business relationships with agents and/or brokers in order to increase sales. Promote sales of health care products to mid market business (51 to 99 employees) customers, through brokers. This includes educating and keeping brokers up to date on products and pricing; evaluating and discussing with brokers, developi

Field inbound calls in a queue from members and providers for purpose of assessment and triage Focus on initial inpatient admission for psychiatric and chemical dependency patients Make patient assessments and determining appropriate levels of care Determine if additional clinical treatment sessions are needed Manage inpatient mental health cases throughout the entire tre

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

External role interacting with clients and broker partners Lead, direct and conduct enrollment/benefit meetings and health fairs for assigned business Educate and consult with employers on enrollment, benefits, value added programs, and electronic service processes Expand customer expertise and reliance on eTools to drive usage and adoption Maintain and provide customer i

Support overall effort to win new business and retain current clients Proactively ensure UHC pharmacy underwriting practices/strategies are current and position company favorably vs. Pharmacy Benefit Manager (PBM) and carrier competition Coordinate and align underwriting pricing practices and strategies with our UW Employer & Individual (E&I) pharmacy partners, as well as

Develop local marketing strategies and work with vendors to execute on those strategies in collaboration with growth leadership. Understand state marketing compliance guidelines for individual Medicaid markets and apply them in every campaign Maintain collaborative relationships with regional Health Plan and growth partners Gain an understanding of the product, the commun

Manage specific technology that is leveraged within our Agent Tools Process improvements related to the technology, taking business related requests and analyzing data to develop further processes within Agent Tools Project management opportunities. New initiatives being implemented that align to the business vision and direction of the government program organization Dev

Partner with the market and regional leadership teams to establish profitable and sustainable, market growth Support development of competitive and affordable products in all lines of business Improve sales & account management performance across each line of business Partner with senior leaders on the creation and execution of the business plan Continue to improve medica

Modeling and forecasting plan performance for new clients Providing renewal & forecast support for existing clients Evaluating individual employer and book of business performance Assisting and supporting underwriting for guarantees & stop loss Supporting other financial and design related requests risk based arrangements Helping to standardize processes as Bind grows Doc

Raising, escalating, and mitigating findings, projections, and recommended actions as well as and managing proposed recommendations and projects Managing and influencing decision making processes within project working groups Managing working group engagements, communications, and meetings Creating meaningful relationships with internal and external business partners Supp

Answer incoming phone calls from customers (i.e. members, providers, facilities) in a call center setting and identify the type of assistance needed (i.e. benefit and eligibility, billing and payments, authorizations for treatment, explanation of benefits, and claims information) Focus on resolving issues on the first call, navigating through complex computer systems to i

Developing and executing email and SMS campaigns in an accurate, efficient manner consistent with marketing strategy, campaign objectives and digital / email best practices Assisting with projects that advance our email marketing capabilities and strategy; interfacing with other departments and external vendors with the purpose of finding the best solution to meet objecti