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

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

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

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

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

Serve as a supervisor overseeing CMA Case Management functions and associated staff. Assumes HSS Coordinator duties when necessary Respect confidentiality and maintain confidences as described in the UHG Employee Handbook and acknowledged through signature by all employees. The ability to maintain confidentiality is a critical and essential component of this position Cond

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 (2 99 EE) through brokers. This includes educating and keeping brokers up to date on products and pricing, evaluating, and discussing with brokers, developing recommendatio

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

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

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,

Mainly handling inbound calling, NO knocking on doors Answer incoming phone calls from prospective members and identify the type of assistance and information the customer needs with the goal to convert the caller to a qualified lead and ultimately sale Ask appropriate questions and listen actively to identify specific questions or issues while documenting required inform

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