You'll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges. UMR , UnitedHealthcare's third party administrator (TPA) solution, is the nation's largest TPA. When you work with UMR , what you do matters. It's that simple . . . and it's that rewarding. In providing consumer oriented health benefit plans to millions of peopl

Develop and maintain strong broker/consultant relationships Develop and maintain key internal relationships Understand customer and broker/consultant needs and provide value added consultation Identify key brokers/consultants for management development Understand goals, operating principles, strategies and competitive position of specialty benefits portfolio In depth Spec

The following duties cover what are generally believed to be principal and essential functions of the job. Specific circumstances may allow or require some people assigned to the job to perform a somewhat different combination of duties. Support enterprise initiatives and product management needs via analysis and consultations Consults with business partners who deliver o

Respond to client inquiries and concerns ensuring timely service delivery of excellent customer satisfaction Create and assign work orders to multiple technicians, subcontractors, and/or vendors Effectively communicate work order details with technicians, subcontractors, and/or vendors, and effectively provide up to date reports on work order statuses Experience working w

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

Works to underwrite cases where general and some complex underwriting principles will be applied and a solid command of the rating tools is required. Frequency of case review will be based on team lead's decision and in accordance to case level review policies Obtains Field Office staff acceptance of expense and reserve levels necessary to achieve planned expense recovery

The KA Field Account Manager is accountable for client and member education as well as escalated service issues of small to mid size, standard/non standard customers. In this position, the KA Field Account Manager is responsible for the following Coordinates, staffs, and conducts open enrollment meetings, wellness fairs and lunch and learns Acts as a strategic partner and

You will work closely with the executive leadership team of these groups as a trusted advisor to help maintain a high performing culture by driving strategic and proactive talent acquisition, development and reward programs that are closely aligned to the overall business and people strategy. Proactively provide advice, guidance, and leadership to executives on organizati

Address any escalated issues sent to them, the SAE, or other field employee Work with the central team and their manager to coordinate resolution Meet with customers quarterly (or more often if requested) to review service related statistics including ideas for improving or enhancing the customer's total service Conduct training/education with customers on UHC eServices,

Organize and manage incoming claims Work through a queue with other team members to identify claim needs Identify billing discrepancies Determine member insurance coverage and eligibility status Ensure compliance with federal and state laws and regulations Sort and organize appeals to identify eligibility needs Communicate with legal teams on appeal status Make offers to

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

The MarTech and Digital Strategies leader is responsible for the following Oversee E&I's implementation of the new Adobe suite of products (AJO, CDP, Assets) Represent E&I's priorities to Evolution program technical leadership. Strategic planning and roadmap of the E&I MarTech stack; a collection of 15+ platforms representing a $4MM+ annual marketing operations investment

Evaluate and assess each request verifying eligibility and specific product Determine benefit level based on site of service Utilize written criteria to approve, pend or send the case to the medical director for review Send cases for pending process when appropriate Maintain at least 98% accuracy of clinical review case notes in Facets Maintain productivity standards and

Provides leadership to and is accountable for the performance and direction through multiple layers of management and senior level professional staff Work most often impacts a large business unit, or multiple markets/sites 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 succe

Address any escalated issues sent to them, the SAE, or other field employee Work with the central team and their manager to coordinate resolution Meet with customers quarterly (or more often if requested) to review service related statistics including ideas for improving or enhancing the customer's total service Conduct training/education with customers on UHC eServices,