UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans.

Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.The Bilingual Sr. Customer Service Representative is responsible for handling all incoming Billing and Eligibility phone calls and for serving as the primary customer interface for departmental inquiries.

Responsibilities: Ensures quality customer service for internal and external customers: Responds to incoming customer service requests, both verbal and written.

Identifies and assesses customers' needs quickly and accurately.

Solves problems systematically, using sound business judgment.

Partners with other billing and eligibility department representatives to resolve complex customer service inquiries.

Monitors delegated customer service issues to ensure timely and accurate resolution.

Applies appropriate communication techniques when responding to customers, particularly in stressful situations.

Informs and educates new customers regarding billing/invoicing set up and billing/payment procedures.

Places outgoing phone calls to complete follow-up on customer service requests as necessary.

Responds to customer service inquiries in writing as necessary.

Processes member terminations (ie phone disenrollment).

Establishes and demonstrates competency in eligibility, billing and receivable systems and associated applications.

Implements customer service strategies and recommends related improvements/enhancements.

Maintains timely, accurate documentation for all appropriate transactions.

Makes corrections and adjustments.

Consistently meets established productivity, schedule adherence, and quality standards.

Proactively seeks to further develop billing and accounts receivable competencies.

Keeps management abreast of all outstanding issues.

Adapts procedures, processes, and techniques to meet the more complex position requirements.

Participates in load balancing.

Addresses special (ad-hoc) projects as appropriate.

Seeks involvement in continuous quality improvement initiatives.

Ensures quality customer service for internal and external customers.

UnitedHealth Group is working to create the health care system of tomorrow.

Already Fortune 25, we are totally focused on innovation and change.

We work a little harder.

We aim a little higher.

We expect more from ourselves and each other.

And at the end of the day, we're doing a lot of good.

Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever.

Now we're looking to reinforce our team with people who are decisive, brilliant – and built for speed.

Qualifications: 1 year of customer service experience analyzing and solving customer problems, OR 1 year of experience in an office setting environment using the telephone and computer as the primary instruments to perform job dutiesBilingual in Spanish/English is requiredAn education level of at least a high school diploma or GED OR 10 years of equivalent working experienceAuthorization to work in the United StatesAvailable to work 40 hours per week anytime within the operating hours of the sitePrior stable work experienceFamiliarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applicationsAbility to navigate a computer while on the phoneAbility to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each productAbility to remain focused and productive each day though tasks may be repetitiveWilling to work and contribute in a team environment.

Ability to execute own assignments under direction of experienced staff.

Ability to balance and prioritize multiple tasks.

Flexible to change.

Responsive to management's requests and suggestion; takes direction.

Develops goals for self and monitors progress.

Seeks assistance as appropriate.

Ability to trouble-shoot problems.

Completes assignments thoroughly, accurately and on time.

Demonstrates the potential for development of strong written and verbal communication skills.

Persists at tasks and maintains high energy level.

Listens effectively.

Seeks additional job responsibilities.

Demonstrated ability in customer service problem resolution and relationship building.

Demonstrates advanced knowledge of Billing/Finance and Eligibility processes, practices and concepts.Has firm understanding of the problems and issues of clients and the business environment.

Demonstrates customer education and negotiation skills.

Basic knowledge of managed care industry preferred.

Demonstrates basic analytical skills.

Orientation towards team environment.

Physical Requirements and Work Environment: Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computerService center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/VUnitedHealth Group is a drug-free workplace.

Candidates are required to pass a drug test before beginning employment.

In addition, employees in certain positions are subject to random drug testing.

Bilingual Senior Customer Service Representative – Plano, TX Job in Plano 75023, Texas US

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans.

Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.

Responsible for working with Senior Management to understand the business scope for a series of large and complex projects.

This person would be responsible for working with multiple IT organizations to create plans to address the business needs\goals for a series of projects within a program.

Once the IT plans are created and approved, this person will be responsible for managing the overall plan and budget, communicating status, and mitigating risk to ensure that the projects are delivered on time with quality.

Very Complex projects within program and managing these projectsWorking with the Business Stakeholders and Sr. Leadership to understand business goals and strategic direction, vision and expectations of projects with in program, and responsible for bringing this back to the IT group to create an IT response to this request.

Work with IT management team to identify resources for these projects and then work with resources to build out project plan.

Work with virtual team, responsible for management and execution of the project(s),Delivering quality projects on time and within budget.

Providing program\project communication to all stakeholders: business, IT, Sr. Management.

Manage and mitigate risk(s) at the project level.

2 plus years of Program Management ExperienceExperience managing multiple projects within a program3 or more years of Project ManagementStrong communication skills (written/verbal)Time Management skillsOrganizational Skills Preferred Skills: Project Management Methodology: PMP certified preferred not requiredProject Lifecycle experiencePlan View ExperienceBackground: Healthcare (preferred not required)Undergraduate degree or equivalent experienceUHG IT lifecycle process experienceUnitedHealth Group is working to create the health care system of tomorrow.

Already Fortune 25, we are totally focused on innovation and change.

We work a little harder.

We aim a little higher.

We expect more from ourselves and each other.

And at the end of the day, we're doing a lot of good.

Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever.

Now we're looking to reinforce our team with people who are decisive, brilliant – and built for speed.

Come to UnitedHealth Group, and share your ideas and your passion for doing more.

We have roles that will fit your skills and knowledge.

We have diverse opportunities that will fit your dreams.

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/VUnitedHealth Group is a drug-free workplace.

Candidates are required to pass a drug test before beginning employment.

In addition, employees in certain positions are subject to random drug testing.

Additional Information: Travel Percentage: 25%

Manager IT Project Management-UHG IT Job in moline 61265, Illinois US

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans.

Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.

Evercare is part of the family of companies that UnitedHealth Group one of the leaders across most major segments of the US health care system.

When you use your skills, talent and energy for the patients of Evercare, you'll be able to do more and do it better.

By tapping into our extensive knowledge base to manage care plans for elderly, disabled, and chronically ill people, you'll ensure that their unique needs are fully understood by all care givers.

In short, you'll help make a huge health care system work like a personalized health care team.

We are seeking a knowledgeable, compassionate RN to provide direct care to hospice patients in skilled nursing facilities.

As the Hospice Case Manager, you would work with other healthcare professionals to determine the best overall care for your terminal patients (prognosis of 6 months or less).

Additionally, you would provide emotional support to the patients' families.

This position offers potential for growth, a friendly staff, and an opportunity to interact with patients and their families on a more personal level.

Primary Responsibilities: Conducting regular visits to skilled nursing facilities for a caseload of approximately 15 patientsCoordinating, assessing, and implementing their careProviding accurate and timely documentation of patient services to reflect plans of careAttending weekly interdisciplinary meetings Discover how fulfilling it is to work among more than 75,000 people who are as committed, driven, intelligent and passionate as you. Put your heart into a career with Evercare.

Qualifications: RN licensure (current, unrestricted) in RI2+ years of clinical experience is required.

Drivers License, Reliable means of transportation and appropriate insurance coverage required Additional Assets Preferred: Experience in long-term careExcellent communication skillsComputer proficiency is a mustBackground in hospice care is highly preferred Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/VUnitedHealth Group is a drug-free workplace.

Candidates are required to pass a drug test before beginning employment.

In addition, employees in certain positions are subject to random drug testing.

Sr Hospice RN Job in Warwick 02818, Rhode Island US

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.

UnitedHealthcare, a UnitedHealth Group company, provides network-based health and well-being benefits and services for employers and consumers nationwide. We use our strength, diversity and innovation to improve the lives of the more than 18 million people who receive our unique products and services. And our endless pursuit for excellence in everything we do extends to your career as well. Join us today for an inspired and purposeful mix of professional growth opportunities and personal rewards.

The Market Medical Director has accountability for ensuring that UnitedHealth Clinical Advancement (UCA) initiatives focusing on affordability, clinical excellence, growth and focused improvement are implemented and successfully managed to achieve targets. This position is responsible for leadership and execution of all market medical expense management and clinical quality activities. Collaborates with the market CEO, UCA staff, and other market staff to implement programs to support and meet market and national clinical operations goals, as well as market, network and sales objectives. Also responsible for direct management and oversight of local market UCA staff.

Overview of Major Responsibilities:

Affordability: Responsibilities for MEM activities include hospital data sharing, physician data sharing, managing the onsite nurses and catastrophic nurse case managers if appropriate.
Clinical Excellence: Oversee the HEDIS data collection process and drive Health Plan accreditation activities.
Growth: Deliver the clinical value proposition in support of the sales and growth activities of the Health Plan including conducting Broker/Client presentations and participating in customer consultations.
Focused Improvement: Responsible for identifying opportunities through participation in local Medical Expense Committees or Market reviews. Active participation in support of Joint Operating Committees.
Management & Other Activities: Responsible for oversight and direct management of Health Plan staff to include completion of performance appraisals, annual salary planning, time and attendance management, overall employee satisfaction.

Excellent telephonic communication skills; excellent interpersonal communication skills.

Ability to develop relationships with network and community physicians and other providers.

Strong knowledge of managed care industry.

Excellent project management skills.

Data analysis and interpretation skills.

Ability to focus on key metrics.

Excellent presentation skills for both clinical and non clinical audiences. Familiarity with current medical issues and practices.

Creative problem solving skills.

Visibility and involvement in medical community.

Strong team player and team building skills.

Unrestricted medical licensed physician; Board Certified in ABMS specialty

5+ years clinical practice experience.

Supervisory skills including clinical mentoring and coaching skills.

To apply for this position, please submit your resume to sseverson@uhc.com, phone 952-936-6499 or apply online at www.unitedhealthgroup.com/careers, req #162177.

UnitedHealth Group invests in employees through a comprehensive compensation and benefits program, 401(k) savings, retirement and stock plans, education reimbursement, and much more.

Diversity creates a healthier atmosphere: an equal opportunity employer, M/F/D/V.

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Market Medical Director (Cleveland) – Unitedhealth Clinical Advancement
Job ID 162177
Position Type Full-Time Employee
Company Name UnitedHealth Group
Location Cleveland, OH
Salary Unspecified
Experience 5-10 Years Experience
Desired Education Level Other

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.UnitedHealth Group is working to create the health care system of tomorrow.    Already Fortune 25, we are totally focused on innovation and change.  We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.   Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant – and built for speed.   Director, Human Capital Development   Contribute to a business segment's performance by designing, developing and implementing learning and development programs, solutions and interventions to equip employees, managers and leaders to drive peak performance and increase organizational capabilities and productivity. Performance consultant, expert thought leader and valued learning and development advisor to assigned business segment for creating and/or managing corporate and/or segment-specific deliverables and outcomes in the following areas of expertise: performance management to create a culture of discipline and accountability; leadership development to increase performance capability; talent management to identify, develop, and deploy key talent; organizational assessment and development to increase organizational effectiveness; and learning systems to manage development content, deliver development solutions, and oversee compliance.Voice of Learning & Development (L&D) to the business market products and services, tools and resources, assist with using core processes and programs; first point of contact for questions, requests, etc.Voice of the Business to L&D what is going on in the business; current and future L&D needs, issues and concerns, feedback and input for program development and improvementClearinghouse for resources, vendors, contemporary issues, etc.Develop, design and drive, end-to-end the Executive Development Program/Masters Series for high potential leadersConsult on and manage executive coaching assignmentsUsing the Learning Investment Portfolio approach, work with segment's functional training teams to ensure alignment and appropriate integration of training efforts across the segment as well as the fit with the enterprise view. Work with training leaders to adopt industry best practices, identify and prioritize opportunities and propose best-in-class training evaluation methods and business impact measurements. Capture L&D investments using the Learning Investment Portfolio tool.Assist the L&D team in building a strong UnitedHealth Group development brand for leaders, managers and employees that is known, supported; assist in assessing the enterprise-wise gaps and identifying ways to close the gaps. Assist with identifying key managerial and leadership skills and competencies needed to drive business strategy.  Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams. Predicts emerging customer needs and develops innovative solutions to meet them.Solves unique and complex problems with broad impact on the business.Participates in the development of business strategy.Develops and manages business plans to achieve objectives.Leads large, complex projects to achieve key business objectives.Translates highly complex concepts in ways that can be understood by a variety of audiences.Influences senior leadership to adopt new ideas, products, and/or approaches.May have segment-wide impact.Directs cross-functional and/or cross-segment teams. – Post-graduate degree in applicable area of expertise or equivalent experience. Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V UnitedHealth Group is a drug-free workplace.  Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.  

Director, Human Capital Development – MN Job in Minneapolis 55401, Minnesota US

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.

Ovations, a UnitedHealth Group company, is dedicated to improving the health and well being of Americans over 50. We currently serve over 3.6 million individuals across the nation, helping to address their unique needs for preventive and acute health care services, deal with chronic conditions, and access to care and services. Come to Ovations and discover the rare combination of a rewarding career and the opportunity to make a difference in people’s lives.

Isn’t it time you had some flexibility in your career? Due to an internal promotion, we seek a caring nurse like you to join our Health Services team in a unique role with tremendous rewards. There are no nights, weekends, holidays or on-call shifts in this position, and you would continue to make a positive impact on your patients. The chosen candidate may ultimately have the chance to work from home and telecommute.

Key responsibilities include:
Managing a caseload of patients at high risk for hospitalization in Pinellas, Hillsborough, Sarasota, Manatee and Charlotte counties
Contacting patients directly, and scheduling in-home assessments
Visiting patients in their homes, and developing a plan of care based on their individual needs
Implementing patient care plans through coordination of treatment, therapy and other services
Following up with patients and other healthcare personnel on various care management efforts

Only licensed Florida RNs will be considered for this role, and solid professional nursing experience is also required. Managed care and utilization management experience is a must, and a background in home health and case management is preferred. Candidates with clinical experience in geriatrics and acute care would be well equipped for this position. Familiarity with Medicare/Medicaid would be ideal, and a BSN is desired. If you meet these criteria, and you’re ready to build a satisfying career with an industry leader, please apply today!

UnitedHealth Group offers a full range of comprehensive benefits, including medical, dental and vision, as well as a matching 401k and an employee stock purchase plan.

If you are interested in growing professionally within an innovative, highly respected organization, we invite you to explore this excellent growth opportunity!

Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V.

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Clinical Care Manager – RN (Work From Home!)
Job ID 162559
Position Type Full-Time Employee
Company Name UnitedHealth Group
Location Tampa, FL
Salary Unspecified
Experience 2-5 Years Experience
Desired Education Level Other