151 to 165 of 6,928
Develop and execute and continually update overall strategies for Medicaid product offering to maximize product growth, member retention, innovation and member and provider experience Drive smart Growth in membership and market share in designated market by developing solid relationships across segments and departments (Network, marketing, clinical, quality, finance) Lead
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P r o v i d e e xc ep t i on a l c u s t o m e r s e r v i ce t o a l l c on s u m e r s a n d m e m be r s o f t h e c li n i c s t a f f F ill s p r e sc r i p t i o n o r de r s a n d m a k e s t he m a v a il a b l e f o r v e r i f i c a t i o n unde r d i r e ct s up e r v i s i o n o f t he r eg i s t e r e d ph a r m a c i s t O r de r s, r e c e i v e s a n d s t
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Practices in accordance with the respective state laws and regulations governing the practice of advanced practice nursing Understands and complies with long term care policies and procedures, including those that regulate nursing facilities and assisted living communities Establishes and maintains effective relationships with members and their legal representatives, faci
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Provides medical care and management to members served by the program and participates in gathering clinical information for medical necessity determinations for service requests. Works with the Landmark Health Medical Director, Director of Health Services, Corporate Director of Health Services, and UM staff in the development and/or implementation of medical management p
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Practices in accordance with the respective state laws and regulations governing the practice of advanced practice nursing Understands and complies with long term care policies and procedures, including those that regulate nursing facilities and assisted living communities Establishes and maintains effective relationships with members and their legal representatives, faci
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Manage a list of assigned Home Care Providers. Schedule and meet weekly with Providers virtually to go over members schedules and care workers check in/outs, ensuring Providers are meeting their compliance obligations. Process incoming calls from Providers resolving multiple issues as well as resolving support tickets submitted within the EVV system by the Provider. Colla
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Conduct in home assessments including an evaluation of past medical history, review of systems, medication reconciliation, vital signs, and comprehensive physical exam Perform evidence based practice screenings including point of care testing (as appropriate) Identify diagnoses to be used in care management and active medical management in the furtherance of treatment For
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Partner with ART Optum Health Team of Teams to define and lead the ART strategy and stakeholder engagement for the Optum Health ART portfolio Coordinate cross functionally to bring together the right competencies, capabilities, and partnerships to address our business partners' biggest challenges, then leverage solutions across the enterprise Collaborate with OGA Global S
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Partner with client and business unit leadership to strategize, prioritize, resource, and deliver transformational security initiatives Serve as a trusted advisor with client and business unit leadership Act as a liaison to ensure cybersecurity practices are built into client and business unit initiatives for the entire lifecycle Act as a trusted point of contact across b
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Telephonic and face to face Provider Education Site Audits Contribute to design and implementation of programs that build positive relationships between the dental plan, providers, practice managers, and internal stake holders Address high level escalated issues and communicate resolution to stakeholders FQHC and large dental practice relationship owner In person visits f
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Professional Accountabilities Adheres to name badge/dress code compliance. Effectively problem solves and actively pursues resolution. Directly communicates with staff, physicians, patients and families. Role models leadership behavior through courtesy, respect and efficiency. Coordinates patient care processes to achieve desired quality outcomes and identifies/controls i
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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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Greets patients as they arrive and manages 20 minute wait time Assists patient with intake processes including copying required documents Collects co payments, co insurance and deductibles and issues receipts Manages cashier box and daily deposits according to company policies Processes walk in patients and visitors Answers phones and schedules appointments Manages medica
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Preps, scans and indexes documents into electronic health record under the appropriate document types utilizing tools provided Provides a detailed analysis of the scanned documents in the queue to ensure all information has been scanned appropriately, is clear and without inaccuracies, possesses the correct patient identification, and is scanned to the correct document ty
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The General Counsel of OptumRx provides leadership and is accountable for all legal, regulatory affairs and risk activities across the OptumRx businesses. This role develops strategies and leads a team of attorneys and other legal professionals to ensure the necessary day to day business legal support to achieve successful performance and results. The General Counsel is a
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