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Provide oversight and performance evaluation through continuous monitoring and analysis of CMARC/CMHRP program requirements and development of strategies based on performance analysis Regularly facilitate efficient, effective meetings with the program to monitor, present, and discuss progress towards program requirements Provide ongoing support and develop recommended act
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Support the transition to modernized analytics Collaborate with key customers to understand key priorities and represent the voice of the customer in all planning and development discussions and decisions Research, evaluate, and deploy new tools, frameworks, and patterns, including identification of gaps and opportunities for improvement of existing solutions Support comm
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Plan, create, and maintain technical documentation for internal and external engineering audiences, including developer notes, FAQs, and other documentation Closely partner with engineering teams to understand product roadmaps and new feature developments Enable users to get the most out of innovative software solutions aimed at modernizing analytics Produce market qualit
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Identify opportunities to enhance existing programs and interventions with an SDOH component and help health plans meet state demands Develop detailed project plans and effectively drive projects to successful completion, on schedule Manage initiative lifecycle for a portfolio of initiatives, identifying opportunities to scale, sunset, or modify programs to drive the best
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Intake and troubleshoot escalated issues and share findings and solutions with operations teams and external partners Identify patterns and partner with various internal and external teams to improve operational processes in order to reduce or mitigate future escalations Analyze business process information (e.g. metrics; analytics) to identify key issues, trends, and pot
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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
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Understand and apply knowledge to support and deliver HEDIS / CMS measure proficiency at a market or reporting population level Ability to work in a self directive manner and apply critical thinking/problem solving skills by referencing available Technical Specifications, Business Process Documentation, Job Aids and other tools for clarity/guidance as needed Ability to pr
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Provides day to day clinical account management support for assigned employer group accounts(s) For assigned employer group account(s) is the liaison to the National Account Growth & Client Management Teams and the employer group account(s) for improving clinical performance and maximizing medical cost reduction opportunities Provides real time data informatics and clinic
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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 Com
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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 Com
Posted Today
Gather and document report requirements for reoccurring and ad hoc regulatory and compliance reports. Develop standard, reoccurring and ad hoc reports for regulatory and compliance oversight using Looker and SQL Manage and support the delivery of fully insured reporting to stakeholders, accurately and on time. Provide feedback on insights obtained through the data to busi
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Assist in end to end provider claims and help enhance call quality Coach, provide feedback and guide others Assist in efforts to enhance ease of use of physician portal and future services enhancements Contribute to design and implementation of programs that build/nurture positive relationships between the health plan, providers and practice managers Help implement traini
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Coach and motivate agents to achieve or exceed sales targets with a focus on quality and compliance Supervise the daily activities of the team by reviewing and analyzing calls / reports, assessing areas of opportunity, managing work assignments and assuring agents are providing a positive consumer experience Develop staff by providing one on one coaching, conducting role
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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
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Accountable for successful deployment of UHC's Clinical Support program at the practice level, including but not limited to, introducing and educating practices on the value/use of reporting tools, patient registries and delivery of reports via UHC's Physician Portal Build and effectively maintain relationship with the practice leadership and key clinical influencers acti
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