166 to 180 of 445
Make Extra Money/Fortune 5 Company/Friendly Work Environment!
Posted 7 days ago
Specific responsibilities include but are not limited to Assist IT ICFR manager with scoping of technologies to determine focus of annual ICFR program for SOX, MAR, FDICIA, and INCA Create and facilitate training to internal testing teams on a broad range of IT ICFR topics Coordinate IT audit requests and methodology updates with internal testing teams and external audito
Posted 8 days ago
Provide case management to members to assess for and find solutions to obstacles to care Link members to healthcare providers and community supports Work with members via telephone and face to face contacts to address healthcare needs Provide field visits to members who have been admitted to behavioral health hospitals Meet with members in the hospital and their home Assi
Posted 8 days ago
Performs medical record reviews of retrospective medical claims relative to all types of fraud, waste, and abuse cases, to include all levels of complexity Documents coding review findings on a claim level and drafts reports of findings to be relied upon in investigations of fraud, waste, and abuse cases Ensures compliance with the UnitedHealthcare (UHC) Fraud, Waste and
Posted 8 days ago
Performs medical record reviews of retrospective medical claims relative to of all types of fraud, waste, and abuse cases, to include all levels of complexity Documents medical review findings on a claim level and drafts reports of findings to be relied on in investigations of fraud, waste, and abuse cases Ensure compliance with the UnitedHealthcare (UHC) Fraud, Waste and
Posted 8 days ago
Identify potential health care business customers Develop business relationships with agents and/or brokers to increase sales Promote sales of health care and ancillary products to Mid Market Employers (51+ EE) through brokers. This includes educating and keeping brokers up to date on products and pricing, evaluating, and discussing with brokers, developing recommendation
Posted 9 days ago
Developing actuarial models Preparing experience analyses Preparing regulatory filings Assisting in the development of financial forecasts and projections 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 other roles you m
Posted 9 days ago
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
Posted 9 days ago
Acts as a TN C&S Health Plan "navigational" specialist for internal and external business partners Conduit for provider issues Drives mitigation plans to resolve provider issues globally with a goal of reducing the number of state level Provider Complaints year 1 year Identify gaps in processes and work with internal Business Partners to resolve Conduct weekly meetings wi
Posted 9 days ago
Manage unit cost budgets, target setting, performance reporting and associated financial models Guide development of geographically competitive, broad access, stable networks that achieve objectives for unit cost performance and trend management Evaluate and negotiate contracts in compliance with company templates, reimbursement structure standards and other key process c
Posted 10 days ago
Obtain and review medical history, conduct physical and psychosocial assessments, analyze and diagnose conditions and develop appropriate plan of care Identify gaps in care, interpret diagnostic test and reports and refer appropriately Identify risk factors and help mitigate barriers to access care and reduce risk Develop interventions to assist members in attaining estab
Posted 10 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 10 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 10 days ago
Performing care management activities to ensure that patients move through the continuum of care efficiently and safely Assessing and interpreting customer needs and requirements Reviews cases and analyzes clinical information in conjunction with Medical Directors to determine the appropriateness of hospitalization Performing Clinician to Physician interaction to acquire
Posted 10 days ago
Maintain calendars and coordinate meetings Create and prepare meeting materials (PowerPoint decks, agendas) and ensure distribution to appropriate individuals in a timely manner Schedule, coordinate, and set up resources and technology (conference rooms, food, Telepresence) needed for meetings/events Make travel arrangements (airline, hotel, ground transportation, office
Posted 10 days ago
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