Key Agent/Agency Performance Agent Development Mentor, coach and engage key agents/agencies through ongoing business and strategy planning. This includes identifying sales opportunities, product positioning, UHC tools, UHC value proposition, compliance, and market education Onboarding Reach out to new agents identified by the PHD to share UHC learning, growth tools and va

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

Handle escalated calls, resolving more complex customer issues Demonstrate outstanding service to identify the source of the caller's issue and work to resolve the inquires in a timely and professional manner Help guide and educate customers about the fundamentals and benefits of consumer driven health care topics such as selecting the best benefit plan options, maximizin

Assess, plan, implement, coordinate, monitor, and evaluate case management activities for offenders being released from state and local prison and for those currently residing at the Community Transition Center, across the continuum of care, within the scope of the case manager's license Coordination and service delivery, Physical and psychological factors, Case managemen

As part of a multi disciplinary care coordination team 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 prio

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

Establish a trusting relationship with youth and family Keep youth and family actively engaged in the planning and implementation of their wraparound care Identifies and build on strengths and culture of youth, family, and support system to create individualized and integrated care plan Collaborate with youth and family's identified support team (community, providers, int

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

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

Assess, plan, and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care Utilize the NYS UAS Assessment as needed in the home or via telehealth to develop a person center service plan to meet the member's needs Identify and initiate referrals for social service programs, including financial, p

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

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

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

Perform initial and concurrent review of inpatient cases applying evidenced based criteria (InterQual criteria) Discuss cases with facility healthcare professionals to obtain plans of care Collaborate with Optum Enterprise Clinical Services Medical Directors on performing utilization management Participation in discussions with the Clinical Services team to improve the pr

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