Ability to manage elements of a health plan compliance program with an understanding of state based government health care programs and products Engage in complex remediation strategy & resolution and promote compliance with applicable laws and contractual obligations for various Medicaid products Ability to flex by working across different markets with varying needs and

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connect

Serve as primary care manager for high medical risks / needs members with comorbid behavioral health needs Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs Develop and implement individualized, person centered care plans inclusiv

Ensuring delivery of cost effective quality care that incorporates recovery, resiliency and person centered services Responsible for Level of Care guidelines and utilization management protocols Responsible for oversight and management, along with the Clinical Director and Clinical Program Director, utilization review, management, and care coordination activities Provide

Identifies opportunities for specialty/enterprise products on all new sales Negotiate with underwriting when necessary Understand and effectively selling multiple products, requiring knowledge of Health Care Reform guidelines and how they differ between level funded and specialty products Develop and maintain solid broker/consultant relationships Properly setting broker a

Responsible for researching and resolving payroll tax issues Act as an SME for payroll tax questions and issues, troubleshoot when needed Partner with HR Operations to manage escalated cases related to payroll taxes, including communication directly to employees based on their individual situation, as well as outside tax vendors/organizations Responsible for running queri

Primary Responsibilities Conducts clinical evaluation of members per regulated timelines, determining who may qualify for complex case management based on clinical judgment, changes in member's health, social determinants, and gaps in care Creates and implements a case management plan in collaboration with the member, caregiver(s), provider(s), and/or other appropriat

Telecommute position/Fortune 5/Excellent Benefits!

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)

Forge relationships with key customers and consultants, and act as main contact for UnitedHealthcare and as "CEO" of their account Renew the customer year over year in the 100 3000 lives segment Clearly demonstrate the value propositions for specialty and ancillary business to improve customer growth and retention Develop and monitor client financial performance, includin

Engage members face to face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medicati

Are you a registered nurse looking for a unique opportunity focused on Home Health? We’re offering a six month paid residency with clinical training, mentorships, classroom training, and in field training for the role of Home Health Case Manager. There will be open positions throughout the year based on the needs of the agency. Primary Responsibilities Classroom tra

Work Life Balance/$10,000 Sign-On Bonus/Excellent Benefits/Fortune 5 Company!

Work Life Balance/$15,000 Sign-On Bonus/Fortune 5 Company/Excellent Benefit Package!

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