Growth Define, develop and implement a data driven, locally focused membership growth strategy for the DC health plan. This includes areas/skills such as Strategic thinking and planning, including project management Market research and analysis Sponsorship and budget planning and management Collaboration with national and health plan teams Community Engagement Thoughtfull

Business Growth by achieving assigned sales/membership growth targets in his/her territory/territories. Sales targets are achieved by building and managing agents and agencies within two sales channels 1) Direct Agents who are independent sales agents who contract directly with UnitedHealthcare to sell Individual and Family plans and 2) Field Marketing Organizations (FMO)

Making outbound calls and taking inbound calls to assess members' current health status Identifying gaps or barriers in treatment plans Providing patient education to assist with self management Interacting with Medical Directors on challenging cases Coordinating care for members Educating members on disease processes Encouraging members to make healthy lifestyle changes

Oversee performance of end to end provider servicing Resolve complex problems and provide guidance to members of own team Drive the design and implementation of programs that build / nurture positive relationships between the health plan, providers, and practice managers Ensure implementation of training and education programs for external providers Identify gaps in netwo

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

Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care Utilize the NYS UAS Assessment as needed in the home or via telehealth to develop a person center service plan to meet the member's needs Identify and initiate referrals for social service programs, including financial, p

Develops and maintains a collegial relationship with contracted and affiliate dentists to support the business efforts of the organization Grievance and Appeals maintains an active liaison with Dental Consultants, reviews dental and medical/dental cases, and oversees the representation of the plan at State level Fair Hearings as requested Works with Quality Director to im

Telecommute position/Fortune 5/Excellent Benefits!

Customer retention, based on established annual goals Strategic planning for multi year initiatives to identify opportunities to better manage healthcare trends Responsible for communicating and managing escalated issues and problem resolution as appropriate Maintains appropriate documentation including action plans, meeting notes, Strategic Customer Business Plans, Sales

Relationship Building Uses our CRM tool to create a proactive engagement plan and monitor engagements for assigned groups Develop and maintain solid customer and broker relationships, in person and telephonically Partner with the local team and other Field Based Staff Develop and maintain key internal relationships Understand customer needs, where to prioritize efforts, a

Telecommute within Boston, MA/Fortune 5 Company/Excellent Compensation Package!

Manage facility based admissions for mental health and substance abuse through the continuum of care Effectively collaborate with treating providers and facilities to ensure consumers are receiving treatment in line with best practice and level of care guidelines Effectively communicate with consumers about their benefit coverage and provide appropriate resources and refe

Making outbound calls to assess members' current health status Identifying gaps or barriers in treatment plans Providing patient education to assist with self management Interacting with Medical Directors on challenging cases Coordinating care for members and services as needed (home health, DME, etc.) Educating members on disease processes Encouraging members to make hea

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 through brokers. This includes educating and keeping brokers up to date on products and pricing, evaluating, and discussing with brokers, developing recommendations on whic

Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, at 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