Assist with care management for high medical risks / needs members with comorbid behavioral health needs As a Care Coordinator Assess 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

Engage members either face to face or over the phone to have a discussion about their health Review available member service records and relevant documentation (e.g., utilization history, functional level, stratification information, current plan of care) Conduct comprehensive member assessment that includes bio psychosocial, functional, and behavioral health needs Utiliz

Make outbound calls, receive inbound calls, coordinate initial orders for home health nursing, enter authorizations, seek/review clinical records every 60 days and documentation Interact with prescribers to offer recommendations to treatment plans, including cost effective alternatives, such as outpatient clinical supports, pharmacy supports or referrals to alternative ca

Contribute and oversee strategic projects, ETL design and architecture, performance tuning activities, Code Reviews, and Best Practices Responsible for approving and certifying the architecture and design of the data warehouse, data marts and BI reports which will support various data initiatives Supervision of development of ETL code with our current toolset, Informatica

Support network pricing strategies and tactics, in collaboration with local network field leaders and network managers Analyze financial impact of provider contracts (e.g., facility; physician; ancillary). Analyze financial impact of corporate initiatives (e.g., policy changes; healthcare affordability) or external regulations (e.g., healthcare reform) Analyze payment app

CI/CD Pipeline build and automation Provision cloud environments for various applications Development of automation tools to support various applications Day to Day collaboration with Scrum Teams, providing support to our developers and testers You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on

Telecommute position/Fortune 5/Excellent Benefits!

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

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)

Manage and monitor client assignments as well as train the account management staff, new hires and ongoing Set team strategy to achieve and surpass goals, and consistently develop and manage a team of Strategic Account Executives and Field Account Managers Relationship Building Build and maintain key client and producer relationships Develop and maintain key internal rela

Management Manage and monitor client assignments Training of field account management staff, new hire and ongoing Maintain an acceptable level of persistency in teams book of business Personnel development and management Set teams strategy to achieve goals Direct and manage service plan Relationship Building Build and maintain key client and producer relationships Develop

Addresses the total patient, inclusive of medical, psychosocial, behavioral, cultural, and spiritual needs Involves the individual patient and caregiver, as appropriate, in decision making Facilitates communication and coordination among members of the care team Provides patient care to include patient assessment prior to physician's/nurse practitioner's examination, serv

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

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

Assess, plan and implement care management interventions that are individualized for each member and directed toward the most appropriate, least restrictive level of care Identify and initiate referrals for both healthcare and community based services; including but not limited to financial, psychosocial, community and state supportive services Develop and implement care