Assesses member current health status and recommends appropriate level of care based on clinical judgment and protocols Adheres to ethical, legal / regulatory and accreditation standards Assesses members understanding of their condition and identifies potential care and / or provider gaps Provides health education and coaches members on treatment alternatives to assist th

Make outbound calls to assess members' current health status Identify gaps or barriers in treatment plans Provide patient education to assist with self management Interact with Medical Directors on challenging cases Coordinate care for members Make referrals to outside sources Coordinate services as needed (home health, DME, etc.) Educate members on disease processes Enco

Participate in a 10 week internship program that includes a comprehensive and structured training curriculum. This will include training on the Medicare business, systems, and sales processes necessary to serve Medicare eligible members and prospects looking for health care coverage Drive sales/enrollments through effective handling of all telephone inquiries from prospec

Answer incoming phone calls from prospective members, identify the type of assistance and information the customer needs with the goal to convert caller to a qualified lead and sale Follow up with members on questions or to review current or new products and services Navigate multiple computer systems to document member information while maintaining active listening and e

Care Management allocation Care Management responsibilities 80% time allocation which includes case consultations with a case load of 45 50 Utilization of hotspotting tool and other internal resource tools that identify at risk AI members Community, relationship building, education 20% (Interventions and efforts to be logged and tracked, reviewed with Manager, including o

Support short and long term operational/strategic business activities through data and claims analysis Recommend, develop, and implement business solutions through research and analysis of data, claims, and business processes Utilize project management skills including planning, development, coordination, monitoring, reporting, and evaluation of program/initiatives Assist

Engage members 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, medication management and me

Field inbound calls in a queue from members and providers for purpose of assessment and triage Focus on initial inpatient admission for psychiatric and chemical dependency patients Make patient assessments and determining appropriate levels of care Participate in member crisis calls Determine if additional clinical treatment sessions are needed Manage inpatient mental hea

Answer incoming phone calls from prospective members, identify the type of assistance and information the customer needs with the goal to convert caller to a qualified lead and sale Follow up with members on questions or to review current or new products and services Navigate multiple computer systems to document member information while maintaining active listening and e

Territory will include priority markets in the Central and West Regions with a focus on MN, IL, TX, AZ, CO, and CA Sales VP qualify top prospect utilizing EDGE sales methodology; identifying/creating compelling events that position UHC for success Individual will be an expert at consultative selling with a demonstrated track record of leveraging UHG capabilities to solve

Perform telephonic member outreach and document telephonic interaction outcomes using appropriate note templates Follow standard operating procedures and utilize required scripting Deliver member outreach using a motivational interviewing style of communication Perform medication and disease state clinical discussions to improve health outcomes Use active and reflective l

improving the quality, cost, and experience of health care. Here, we focus on delivering the best patient care, rather than volume. Through innovation and superior care management, we support patients and your well being as a team member. Join a team at the forefront of value based care and discover the meaning behind. The Nursing Internship Program is full time, 40 hours

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