Optum

Enroll Medicare beneficiaries into health plans and manage territory-specific sales strategies. | Requires health insurance licensure, sales experience, and ability to travel extensively. | For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. The Sales Account Manager (SAM) is a field-based position charged with enrolling Medicare beneficiaries, residing in a skilled nursing facility into the UnitedHealthcare Institutional Special Needs Plan (ISNP). We have openings in multiple locations that include CT, Syracuse, NY and the Hudson Valley, NY where if you reside in one of those markets, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: • Utilize the national sales model to generate leads and enroll beneficiaries into the UnitedHealthcare Nursing Home plan • Develop and manage account specific strategies to educate and engage facility personnel, resulting in the generation of interested residents and/or families (responsible parties) • Utilize traditional sales strategies to uncover needs and introduce features and benefits of the plan • Generate enrollments consistent with targets established for the territory • Document all activity to ensure compliance with Medicare Marketing Guidelines 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 succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • Appropriate state health insurance licensure or the ability to obtain within 90 days of hire • Ability to maintain licensure and product certification based on policies and procedures • Experience meeting or exceeding sales goals • Sales experience in a B2C or B2B setting or experience working in a skilled nursing facility • Demonstrated account management skills (including planning, documentation and measurement) • Ability to maintain a state driver's license or arrange for transportation in the field • Willing or ability to travel 90% throughout the designated local territory • Demonstrated ability to work a variety of hours, early morning, evenings and weekends, as required by various sales activities Preferred Qualifications: • B2B and B2C experience • Experience with a CRM or the ability to show technical skills • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $50,000 to $115,000 annually based on full-time employment. This role is also eligible to receive bonuses based on sales performance. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment

Review and assess medical records and treatment plans to determine the necessity and appropriateness of healthcare services, collaborating with healthcare professionals and communicating decisions effectively. | Minimum 2 years experience in utilization management or related healthcare roles, strong knowledge of medical terminology and healthcare regulations, excellent communication skills, and proficiency with EMR systems. | Job Title: Utilization Management Representative Company Overview: Optum is a leading health services and innovation company dedicated to improving the health system and delivering better care for patients. As part of the UnitedHealth Group family, Optum combines technology, data, and expertise to transform healthcare delivery and management. Our Southern California Physicians Managed Care Services division focuses on providing exceptional managed care solutions to improve patient outcomes and client satisfaction. Role Overview: As a Utilization Management Representative, you will play a critical role in evaluating and managing healthcare services to ensure appropriate care delivery. You will work closely with healthcare providers, patients, and internal teams to review medical necessity and support efficient utilization of resources. What You'll Do: - You will review and assess medical records and treatment plans to determine the necessity and appropriateness of healthcare services. - You will collaborate with physicians, nurses, and other healthcare professionals to facilitate timely and effective care decisions. - You will communicate with patients and providers to explain utilization management decisions and address inquiries. - You will document all case reviews and decisions accurately in compliance with regulatory and company standards. - You will participate in quality improvement initiatives to enhance utilization management processes. - You will stay current with healthcare regulations, policies, and best practices related to utilization management. - You will support appeals and grievance processes as needed. What You Bring: - Minimum of 2 years experience in utilization management, case management, or a related healthcare role. - Strong knowledge of medical terminology, healthcare regulations, and managed care principles. - Excellent communication and interpersonal skills to effectively interact with diverse stakeholders. - Proficiency in electronic medical records (EMR) systems and Microsoft Office Suite. - Ability to analyze clinical information and make sound decisions under pressure. Bonus Points If You Have: - Certification in Case Management (CCM) or Utilization Review (URAC) accreditation. - Experience working within managed care organizations or health insurance companies. - Familiarity with Southern California healthcare providers and networks. - Bilingual skills, particularly in Spanish. What We Offer: - We offer competitive salary and comprehensive benefits including medical, dental, and vision coverage. - We offer opportunities for professional development and career advancement within a growing healthcare organization. - We offer a supportive and inclusive work environment that values collaboration and innovation. - We offer flexible work schedules and remote work options to support work-life balance. - We offer employee wellness programs and resources to promote health and well-being. Ready to Apply? To join our team as a Utilization Management Representative, please submit your resume and cover letter through our careers portal at www.optum.com/careers. We look forward to reviewing your application and exploring how you can contribute to our mission of improving healthcare delivery.

Review and assess medical records to determine care necessity, collaborate with providers, ensure compliance, document decisions, and support quality improvement. | Minimum 2 years experience in utilization or case management, strong knowledge of medical terminology and healthcare regulations, excellent communication skills, and proficiency with EMR systems. | Job Title: Utilization Management Representative Company Overview: Optum is a leading health services and innovation company dedicated to improving the health system and delivering better care to patients. As part of the UnitedHealth Group family, Optum combines technology, data, and expertise to transform healthcare delivery and management. Our Southern California Physicians Managed Care Services division focuses on providing exceptional managed care solutions to improve patient outcomes and client satisfaction. Role Overview: As a Utilization Management Representative, you will play a critical role in evaluating and managing healthcare services to ensure appropriate care delivery. You will work closely with healthcare providers, patients, and internal teams to review medical necessity and support efficient utilization of resources. What You'll Do: - You will review and assess medical records and treatment plans to determine the necessity and appropriateness of care. - You will collaborate with healthcare providers to obtain additional information and clarify treatment details. - You will communicate decisions regarding utilization management to providers and patients clearly and professionally. - You will ensure compliance with regulatory requirements and company policies in all utilization management activities. - You will document all case reviews and decisions accurately in the system. - You will participate in quality improvement initiatives to enhance service delivery. - You will stay current with healthcare regulations, policies, and best practices related to utilization management. - You will support the team in meeting performance goals and client expectations. What You Bring: - Minimum of 2 years experience in utilization management, case management, or a related healthcare role. - Strong knowledge of medical terminology, healthcare regulations, and managed care processes. - Excellent communication and interpersonal skills to interact effectively with providers and patients. - Proficiency in electronic medical records (EMR) systems and Microsoft Office Suite. - Ability to analyze clinical information and make sound decisions based on guidelines. - Detail-oriented with strong organizational and documentation skills. Bonus Points If You Have: - Certification in Case Management (CCM) or Utilization Review (URAC) credentials. - Experience working in a managed care or insurance environment. - Familiarity with Southern California healthcare providers and systems. - Bilingual skills, especially in Spanish, to support diverse patient populations. What We Offer: - We offer competitive salary and comprehensive benefits including health, dental, and vision insurance. - We offer opportunities for professional development and career advancement within Optum. - We offer a supportive and inclusive work environment that values diversity. - We offer flexible work schedules and remote work options to support work-life balance. - We offer employee wellness programs and resources to promote your health and well-being. Ready to Apply? To join our team as a Utilization Management Representative, please submit your resume and cover letter through the Optum careers website. We look forward to reviewing your application and exploring how you can contribute to our mission of improving healthcare delivery.

Provide exceptional customer support by addressing inquiries, resolving issues, and facilitating communication between clients and healthcare providers. | At least 2 years of customer service experience, strong communication skills, proficiency with CRM software and Microsoft Office, and ability to work in a hybrid environment. | Job Title: Customer Service Representative Company Overview: Optum is a leading health services and innovation company dedicated to improving the health system and delivering better care to patients. With a clinician-led approach, Optum combines technology, data, and expertise to transform healthcare experiences and outcomes. Our Golden, CO office is a hub for passionate professionals committed to making a difference in the community. Role Overview: As a Customer Service Representative at Optum, you will be the frontline ambassador for our organization, providing exceptional support and guidance to our clients and members. This role is essential in ensuring a positive customer experience by addressing inquiries, resolving issues, and facilitating communication between clients and healthcare providers. What You'll Do: - You will respond promptly and professionally to customer inquiries via phone, email, and in-person interactions. - You will assist customers in navigating healthcare services and understanding their benefits. - You will document and track customer interactions accurately in our systems. - You will collaborate with internal teams to resolve complex customer issues efficiently. - You will maintain up-to-date knowledge of company products, services, and policies. - You will contribute to continuous improvement initiatives by providing feedback on customer experiences. - You will adhere to all regulatory and compliance standards related to customer service. - You will support the hybrid work environment by working three days per week in the Golden, CO office. What You Bring: - You have at least 2 years of experience in customer service, preferably in healthcare or related industries. - You possess strong communication skills, both verbal and written. - You are proficient with customer relationship management (CRM) software and Microsoft Office Suite. - You demonstrate problem-solving abilities and a customer-focused mindset. - You have the ability to work effectively in a hybrid work environment. Bonus Points If You Have: - Experience with healthcare insurance processes and terminology. - Bilingual skills, especially in Spanish. - Familiarity with HIPAA regulations and compliance. - Previous experience working in a clinician-led organization. What We Offer: - We offer a competitive salary and comprehensive benefits package. - We offer opportunities for professional development and career growth. - We offer a supportive and inclusive work culture. - We offer a flexible hybrid work schedule to balance work and life. - We offer wellness programs and employee assistance resources. Ready to Apply? Submit your resume and cover letter through our online application portal at careers.optum.com. We look forward to welcoming you to our team!

Build, maintain, and support high-availability Azure PostgreSQL and MS SQL Server databases, manage data distribution and security, perform upgrades and migrations, and participate in 24/7 on-call rotations. | 10+ years managing Azure PostgreSQL and MS SQL Server Always On Availability Groups, expert-level T-SQL and PL/pgSQL skills, experience with database health monitoring tools, data transformation tools, and adherence to ITIL and security standards. | Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. This individual will be building databases on Azure postgreSQL and SQL Server of high availability. Designing and implementing databases in accordance to end users information needs and views. Defining users and enabling data distribution to the right user, in appropriate format and in a timely manner Payer Service Platform : PSP is an Electronic Funds Transfer and Electronic Remittance Advice (EFT/ERA/MEOB/835) Solution from Optum™. The application is a fully integrated claims settlement solution that brings electronic data and banking functions together, simplifying a payer’s workflow, lowering costs, and improving provider relations at the same time. You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: • Build and maintain high-availability databases on Azure PostgreSQL and SQL Server • Design and implement databases based on end-user requirements • Define users and manage data distribution securely and efficiently • Perform day-to-day support operations, resolving issues with business users and developers • Adhere to ITIL processes, security standards, SLAs, and compliance requirements • Participate in 24/7 on-call rotation for database maintenance and support • Design and build new infrastructure, conduct capacity analysis and planning for new Databases • Perform upgrades and migrations for MS SQL Server and PostgreSQL • Document DBA processes and share knowledge with the team • Manage server and database security, including user roles and Active Directory permissions 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 succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • 10+ years of experience with MS SQL Server (2016-2019) and Azure PostgreSQL (11-15) • 10+ years managing Azure PostgreSQL Flexible Server HA and PgBouncer • 10+ years managing MS SQL Server Always On Availability Groups across subnets • 5+ years of expert-level T-SQL and PL/pgSQL (PSQL) knowledge • 5+ years in database modeling and design • 5+ years monitoring database health, performance, and availability using tools like Redgate and pganalyze • 5+ years optimizing SQL queries for performance and data integrity • 5+ years experience with data transformation tools: SSIS, BCP, Bulk Insert, Azure Data Factory Preferred Qualifications • Bachelor’s Degree • Proven experience as a DBA in fast-paced, high-growth environments • Proven attention to detail and task completion with high accuracy • Proven excellent written, verbal, and interpersonal communication skills • All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug – free workplace. Candidates are required to pass a drug test before beginning employment.

Manage and execute social media and marketing campaigns, collaborate across teams to create engaging content, monitor and report on social media performance, and oversee brand voice and budget. | 3+ years marketing experience, 2+ years social content creation and community management, proficiency with social media management platforms, strong writing and project management skills. | Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Quality at Optum means striving for excellence in everything we do in order to help us achieve our Mission. Simply put, it's in our DNA and why we're in business - to help people. Our Mission serves as our why; our Values unite us around how we will achieve it. Because when we follow our Mission and live our Values, we deliver Quality. The Social Media Specialist is responsible for managing and executing social media and marketing campaigns on behalf of Crystal Run Healthcare and Optum Medical Care. This role will play a critical role within the Optum NY/NJ marketing team, supporting our social strategy, elevating regional priorities, managing our brand voice, developing unique ideas, producing engaging, relevant content, and balancing speed and quality. You will collaborate across creative and social media teams to create and amplify regional content, ensuring that our messages are unique, engaging and search-friendly. Candidate must have content creation experience, a passion for strategic thinking, and a proven history in managing and growing social channels. This role requires a detailed understanding of publishing tools, analytical tools, and social marketing technology including native platforms such as Facebook, Instagram, Twitter, LinkedIn, YouTube. The role is responsible for managing budget across the social media platforms and providing regular and accurate monthly reporting on performance. The ideal candidate will work across our marketing team and business to collect and polish content to be used across our social channels, marketing campaigns, and website. Proactive cross-team collaboration and synergy identification is a key component of this role. You must be a well-organized, highly motivated, roll up your sleeves, self-starter with a passion If you are located in Middletown, NY, Chappaqua, NY, or Lake Success, NY, you will have the flexibility to work remotely* as you take on some tough challenges. This position follows a hybrid schedule with four in-office days per week. Remote - Hybrid; Option to work in Middletown, NY, Chappaqua, NY, or Lake Success, NY Primary Responsibilities • Oversee social media plan from start to finish (inclusive of strategy, research, development, execution, monitoring and reporting), making sure that all aspects of the posts are executed smoothly, on time, and within brand standards • Work in collaboration with director and all internal cross functional teams including operations, provider marketing, patient experience, communications, social media, and analytics teams to plan and execute social media campaigns • Create engaging content plans that are responsive to business events and aligned with strategic objectives • Manage creative development process with internal/external creative partners, ensuring content is informative, appealing, and on-brand • Utilize social media management platform to post and optimize performance, including social listening, reporting on analytics, and community management • Prepare monthly performance reports and work with national team to review performance on national organic channels 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 succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications • 3+ years of experience in marketing, advertising or related field • 2+ years of creating social content across a wide variety of paid, owned and earned channels (Meta, LinkedIn, X) • 2+ years of experience utilizing social media management platforms (Meta Business suite, LinkedIn campaign manager, Sprinklr, Hootsuite or similar) for scheduling and performance monitoring • 2+ years of community management experience on social platforms • Proven solid writing skills • Proven exceptionally organized and detail oriented • Proven solid project management skills with experience using Asana, Adobe Workfront or similar platforms Preferred Qualifications • Canva and Adobe suite product experience • Healthcare experience • Agency and/or design experience • Proven collaborative problem solver • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Review pre-authorization requests for skilled nursing and rehabilitative services, coordinate patient transitions, and communicate review outcomes. | Active RN license, 3+ years clinical experience, experience supervising assistants, physician engagement skills, and ability to work specified shifts remotely. | Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual’s physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member of our naviHealth product, we help change the way health care is delivered from hospital to home supporting patients transitioning across care settings. This life-changing work helps give older adults more days at home. We’re connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together. Why naviHealth? At naviHealth, our mission is to work with extraordinarily talented people who are committed to making a positive and powerful impact on society by transforming health care. naviHealth is the result of almost two decades of dedicated visionary leaders and innovative organizations challenging the status quo for care transition solutions. We do health care differently and we are changing health care one patient at a time. Moreover, have a genuine passion and energy to grow within an aggressive and fun environment, using the latest technologies in alignment with the company’s technical vision and strategy. The Pre-Service Coordinator plays an integral role in optimizing the patient’s recovery journey. The Pre-Service Coordinator is responsible for reviewing pre-authorization requests for skilled nursing and rehabilitative services and determining if requests meet medical necessity for the requested level of care. The position coordinates the transition of patients from the community or acute setting to the next appropriate level of care while following established facility policies and procedures. This position is full-time (40 hours/week) Monday-Friday 1pm-10pm Central Time. It may be necessary, given the business need, to work occasional overtime. You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities • Perform in a hybrid role as either clinical “gatherer and authorization document creator” or solely as a clinical and authorization “reviewer” for all prospective, concurrent, and retrospective requests within established parameters • Perform review for all direct admits to SNF via physician office, ED or HH • Perform all expedited prospective reviews, including patient oral and/or written notifications • Perform all standard prospective reviews, including patient oral and/or written notifications • May have EMR access to mirror Inpatient Care Coordinator partner access • Coordinator peer to peer reviews with Medical Directors • Notify hospitals and SNFs of review outcomes for non-engaged patients • Partner with Medical Directors for Pre-Service Coordinator training as needed • Complete processes as it relates to pre-service authorizations • Educate facilities on the pre-service denial process • Participate in the clinical phone queue to ensure customer SLA’s are met • Support new delegated contract start-up to ensure experienced staff work with new contracts 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 succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications • Active, unrestricted RN license in state of residence • 3+ years of clinical experience • Experience in oversight and supervision of assistants (CNAs, PTAs, OTAs) • Experience with physician engagement and crucial conversations • Ability to work posted shift weekly Monday-Friday 1pm-10m in Central Time • Ability to work any shift including the flexibility and willingness to work an early or late shift and / or longer than normal hours to accommodate peaks in volume of work based on business need Preferred Qualifications • 2+ years of Case Management experience • Experience in acute care, rehab, OR skilled nursing facility environment • Experience with performing clinical audits to improve quality standards or performance • Experience in working with geriatric population • Managed Care experience • ICD - 10 and InterQual experience • CMS knowledge • All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $34.23 to $61.15 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission. Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Manage provider performance improvement programs focusing on Medicare Advantage quality metrics through data analysis, provider education, and relationship management with significant travel. | 5+ years healthcare experience including Medicare Advantage and provider-facing roles, strong analytical skills, willingness to travel extensively, and residency in Kansas. | Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Practice Performance Manager - is responsible for program implementation and provider performance management which is tracked by designated provider metrics, inclusive minimally of 4 STAR gap closure and suspect closure. The individual in this role is expected to work directly with care providers to build relationships, ensure effective education and reporting, proactively identify performance improvement opportunities through analysis and discussion with subject matter experts; and influence provider behavior to achieve needed results. This individual will review charts (paper and electronic - EMR), identify gaps in care and open suspect opportunities. Work is primarily performed at physician practices on a daily basis. If you reside in Kansas, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities • Functioning independently, travel across assigned territory to meet with providers to discuss UHC and Optum tools and UHC incentive programs for quality reporting, focused on improving the quality of care for Medicare Advantage Members • Establish positive, long-term, consultative relationships with physicians, medical groups, IPAs and ACOs • Develop comprehensive, provider-specific plans to increase their HEDIS performance and improve their outcomes • Access PCOR and utilize other available reporting sources including but not limited to (InSite, Spotlight, Doc360, Provider Scorecard, CPT II Report) to analyze data and prioritize gap and suspect closure, identify trends and drive educational opportunities • Coordinates and provides ongoing strategic recommendations, training and coaching to provider groups on program implementation and barrier resolution • Training will include Stars measures (HEDIS/CAHPS/HOS/medication adherence), coding for quality care (CPT II) and exclusions (ICD-10-CM), and Optum program administration including use of plan tools, reports and systems • Lead regular Stars and risk adjustment specific JOC meetings with provider groups to drive continual process improvement and achieve goals • Provide reporting to health plan leadership on progress of overall performance, MAPCPi, gap closure, and use of virtual administrative resources • Facilitate/lead monthly or quarterly meetings, as required by plan leader, including report and material preparation • Collaborates and communicates with the member's health care and service with our interdisciplinary delivery team to coordinate the care needs for the member • Partner with providers to engage in UnitedHealthcare member programs such as HouseCalls, clinic days, Navigate4Me • Willing to travel up to 75-80% for business meetings (including client/health plan partners and provider meetings) and 20-25% remote work 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 succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications • 5+ years of healthcare industry experience • 2+ years of Medicare Advantage including Stars and Risk Adjustment • 1+ years of provider facing experience • Intermediate level experience Microsoft Office experience including Excel with exceptional analytical and data representation expertise and PowerPoint • Willing to travel 75-80% for business meetings (including client/health plan partners and provider meetings) and 20-25% remote work • Driver's License and access to reliable transportation • Reside in the state of Kansas Preferred Qualifications • Registered Nurse • Experience working for a health plan and/or within a provider office • Experience with network and provider relations/contracting • Experience retrieving data from EMRs (electronic medical records) • Experience in management or coding position in a provider primary care practice • Knowledge base of clinical standards of care, preventive health, and Stars measures • Knowledge of billing or claims submission and other related actions • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Achieve sales goals by developing and executing territory business plans, building and maintaining referral sources, coordinating with manufacturing partners, and supporting customer needs in a biologics sales role. | 2+ years of B2B selling or relevant biologics experience, proven sales performance, local residence near Seattle WA, driver's license and reliable transportation. | Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. Optum Infusion Pharmacy, a division of OptumRx, is searching for a patient-inspired, results oriented and collaborative sales professional to join our Biologics Sales Team. This is a high-performing Team, and this role is critical to the growth of our division. The Regional Account Manager RAM (Biologics Specialist) will call on Biologics specialists focused on generating new referrals. They will be expected to achieve sales goals by developing and executing on their territory business plan, maintaining, and growing referral sources, coordinating sales efforts with strategic manufacturing partners, and supporting the needs of our customers. The RAM will also partner closely with their Intake, Operations and Nursing peers to achieve positive patient outcomes. The successful candidate will have a proven track record of achieving results, building relationships, customer focus, and promoting all sales and marketing programs. Job will require occasional evening and weekend event attendance. This is customer-facing sales position, and you will be expected to travel to clinics and hospitals to meet your customers. This position will cover WA state. Candidate must live in commutable distance to Denver, CO, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: • Achieve the territory sales goals through effective business planning, sales execution and fully leveraging our customer selling model • Promote a patient-centered culture that strives to exceed needs, requirements, and expectations by educating and developing rapport with external customers • Utilize available sales and market data to identify key customers • Identify & build relationships with key customers in target accounts • Demonstrate a thorough understanding of disease state and treatment options and their impact on patients, payers, institutions, health systems and healthcare providers • Collaborate with key internal stakeholders (Intake, Operations, Nursing) to execute on key selling strategies • Be a Problem solver with a willingness to think creatively to achieve solutions 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 succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • 2+ years of business to business selling experience OR relevant Biologics experience • Proven ability to drive results in a challenging and ambiguous market by building a book of business from scratch • Proven consistent track record of top performance (top 30%) • Proven recognition for overachievement of performance goals (ex. President's Club) • Primary residence must be within a commutable distance to Seattle WA • Driver's License and access to a reliable transportation Preferred Qualifications: • Medical selling experience (ex. medical device, lab sales) • Experience selling infusion products as manufacturer and/or infusion pharmacy • Demonstrated experience working individually and as a Team to achieve results • Proven solid team player that has a customer service approach and is solution oriented • Proven tenacious and motivated outside-the-box thinker who excels in a collaborative team setting Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,000 to $130,000 annually based on full-time employment. This role is also eligible to receive bonuses based on sales performance. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Perform outbound calls for member outreach, maintain documentation, and coordinate with teams to ensure positive member experiences. | High school diploma or GED, Certified or Registered Medical Assistant certification, and 1+ years of customer service experience in a contact center environment. | Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. The Member Experience Representative supports member outreach activities to ensure a positive customer experience. Will perform welcome calls, disenrollment calls, member check-in calls, and health screening reminder calls via outbound telephone calls to health plan members. If you are located in Pearland, TX, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: • The Member Experience Representative maintains documentation in share point and other systems to accurately capture call outcomes • The Member Experience Representative coordinates with other departments and teams to fully support a positive member experience 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 succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • High School Diploma or GED from an accredited program • Certified or Registered Medical Assistant • 1+ years of customer service experience in a contact center environment • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16.00 to $27.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Lead advanced analytics projects on healthcare claims data to deliver insights, manage cost savings initiatives, and influence senior leadership while mentoring junior analysts. | 7+ years healthcare claims experience, 5+ years auditing/billing/coding claims, knowledge of CMS rules and billing codes, project management skills, and proficiency in Excel, SQL, SAS, and Tableau. | Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. We are seeking a highly skilled and strategic Principal Data Analyst to lead advanced analytics initiatives across our healthcare operations. This role is responsible for designing and delivering data-driven insights that inform business decisions, improve operational efficiency, and enhance client outcomes. The ideal candidate will be a subject matter expert in healthcare claims data, with deep experience in business intelligence tools, statistical analysis, and stakeholder engagement. As a Principal Data Analyst, you will work closely with cross-functional teams to define data requirements, develop analytical models, and present actionable insights to senior leadership. You will also mentor junior analysts and contribute to the development of best practices in data governance, visualization, and reporting. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: • Develop and manage a portfolio of cost savings initiatives with measurable client impact • Lead conceptualization to completion of analytics projects and product development efforts • Perform iterative analytical and investigative work to support concept development and solution validation • Establish and maintain matrixed relationships with internal stakeholders to align and deliver payment integrity initiatives • Influence senior leadership to adopt innovative ideas, approaches, and products • Recommend changes to product development based on market research and emerging trends • Serve as an industry thought leader and SME in professional and facility medical claims, pricing, and cost management • Create specifications for data structuring, product modeling, and dashboard development • Deliver activity and value analytics to clients and stakeholders using BI and statistical tools • Use tools such as Excel, SQL, SAS, Tableau, and PowerPoint to build solutions and communicate insights • Act as a company thought leader and functional SME • Provide a broad business perspective and support senior leadership • Develop pioneering approaches to emerging industry trends • Lead cross-functional collaboration and influence without direct authority 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 succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • 7+ years of experience in healthcare claims lifecycle (submission, processing, adjudication, payment) • 5+ years of experience auditing, billing, and/or coding claims • 5+ years of experience in the healthcare industry (Medicare, Medicaid, Commercial, Behavioral Health, Home and Community) with deep exposure to Payment Integrity • 3+ years of experience in consultative roles with cross-functional collaboration • 3+ years of experience interpreting data sets and presenting proposals to stakeholders • 3+ years of project management experience • Advanced proficiency in Excel (pivot tables, formulas, charts) • Working knowledge of CMS rules, billing codes, and related services • Solid analytical mindset, critical thinking, and communication skills • Proven ability to lead without authority in high-paced environments Preferred Qualifications: • Coding certification (AAPC or AHIMA) • 3+ years of experience in claims adjudication or revenue cycle management • 2+ years of experience in matrixed, adaptive environments with tight deadlines • Proficiency in SQL, SAS, and other statistical programs • Solid project management and problem-solving skills • Exceptional presentation, communication, and negotiation abilities • Proficiency in Visio, Tableau, PowerPoint • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Develop and execute strategic plans to grow provider client accounts, lead cross-functional teams, negotiate contracts, and ensure customer satisfaction and revenue growth. | 7+ years in healthcare strategic or leadership roles with experience driving KPIs, managing C-suite relationships, leading matrixed teams, and residing in EST or CST time zones with travel availability. | Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Provider Market Senior Account Executive is the executive point of contact for key strategic Provider clients. The Senior Account Executive is charged with developing and executing strategic and commercial plans to achieve above-market growth in delivering Provider solutions to our customers. The senior account executive is accountable for the profitable growth and deployment of the overall Provider portfolio within the client relationship working directly with customers and internal and external partners to deliver on customer commitments. Where appropriate, the senior account executive will work with team members across Optum Insight, Optum Health, Optum RX and UHC to align on customer plans and priorities. The senior account executive is accountable for driving growth within the account as it contributes to the regional and market P&Ls. You will engage the matrixed teams in support of account objectives for revenue, earnings, growth and client satisfaction. This includes engaging with the sales teams, operations, product, and technology teams, as well as other groups at the Optum level required to deliver upon our aggressive growth and innovation objectives. This role will be strategically aligned to our Northeast Region which includes the following areas: OH, PA, NY. Travel for this role will be required 25-50% of the time based on the client's need. If you are located in the EST or CST time zone, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities • Build, nurture and grow intimate, consultative relationships with key Provider clients to understand the client's strategy and business needs • Constantly assesses the value that Optum solutions are delivering • Lead team members across the matrix to develop approaches that increase the value we provide and increase the impact Optum has on the client's business • Create value story consistent with the client's strategy. Present value of Optum solutions to various levels within the client, including executives, decision makers and key influencers. This may include on-site or virtual meetings • Ensure service and delivery commitments to client are met • Coordinate and influence service delivery and effective operational interface between clients and Optum teams related to Provider solutions. Work with Optum teams to drive resolution to performance opportunities and issues • Negotiate renewals, contractual agreements, statements of work, and performance guarantees while serving as liaison with contracting / legal / finance • Ensure the realization of expected client savings and Optum revenue growth goals through performance management, contract renewals, and identification / advancement of upsell opportunities in partnership with sales • Develop and present reporting on savings achievements, opportunities, and service level agreements • Responsible for business process management and entry of timely updates to CRM System (SF.com), including but not limited to client planning, opportunity management, contact management, current solution footprint, etc. • Drive outcomes with internal matrix business stakeholders across Optum to ensure customer centricity, high NPS scores and renewal rates, delivery against customer needs and expectations, profitable growth, and representation for the voice of the customer in our current and future products and technologies • Influence external customers at the VP & C-Suite level as a trusted executive partner • Deliver exceptional customer Net Promotor Score (NPS) results 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 succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications • 7+ years of experience in a strategic, leadership, consultant or related role within the healthcare industry where you have been responsible for driving various KPIs/metrics and growth • 5+ years of experience working with stakeholders and business leaders to drive outcomes • Experience in driving deep, productive relationships with external clients • Demonstrated success building and evolving relationships with internal C-suite and matrixed stakeholder teams • Proven history of leading, influencing and managing indirect, matrixed teams with successful people and team leadership experience - motivating, mentoring, and developing talent • Demonstrated track record of success driving client success across highly complex and matrixed organizations • Proven ability to analyze complex market opportunities and develop creative solutions to a wide variety of unique market problems • Demonstrated track record of active collaboration, engagement, oversight and strategy development of key growth opportunities • Proven level of understanding of the healthcare market, specifically in the provider market • Ability to travel 25-50% of the time based on business needs • Reside in Eastern or Central time zone region of the U.S. • Driver's License and access to reliable transportation • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $90,000 to $195,000 annually based on full-time employment. This role is also eligible to receive bonuses based on sales performance. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Manage provider relationships, analyze and report performance metrics, drive quality and cost improvement initiatives, and collaborate with internal and external stakeholders to support healthcare business goals. | 3+ years in medical or health plan setting, knowledge of Medicare laws and operations including HEDIS and CMS models, proficiency in MS Office, ability to travel 25%, and valid driver's license. | For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. The Account Manager has geographic responsibility for the quality and economic performance of the physician practice with the goal of developing a high performing provider network within the State of Kansas and Missouri. This includes analyzing, reviewing, forecasting, trending, and presenting information for operational and business planning. The Account Manager will develop and sustain a strong day-to-day relationship with stakeholders, the physician and office staff to effectively implement the business solutions developed by the Client Services leadership team. The Account Manager is accountable for overall performance and profitability for their assigned groups as well as ownership and oversight to provide redirection as appropriate and approved. The responsibilities of this position include capabilities in the following areas: strategic planning and analysis; understanding of HEDIS, Star ratings, accurate documentation, and coding; advanced communication skills; and the ability to develop clear action plans and drive process. If you are located in Manhattan, KS, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: • Solid analytical skills required to support, compile, and report key information • Drive processes that directly impact Revenue, HEDIS/STAR measures and Quality Metrics, and total cost of care, as appropriate • Use data to identify trends, patterns and opportunities for the business and clients. Develop business strategies in line with company strategic • initiatives • Engage provider staff and providers in analysis and evaluation of functional models and process improvements; identify dependencies and priorities • Evaluate and drive processes, provider relationships and implementation plans • Produce, publish, and distribute scheduled and ad-hoc client and operational reports relating to the performance of related metrics and goals • Collaborate with internal leaders to foster teamwork and build consistency throughout the market • Serves as a liaison to the health plan and all customers • Requires solid presentation skills, problem solving and ability to manage conflict and identify resolutions quickly • Have the ability to communicate well with physicians, staff, and internal departments Essential Job Functions: • Educate providers to ensure they have the tools needed to meet quality, coding and documentation, and total medical cost goals per business development plans • Develops strategies and create action plans that align provider pools and groups with company initiatives, goals, quality outcomes, program incentives, and patient care best practices • Drive processes and improvement initiatives that directly impact revenue, HEDIS/STAR measures and quality metrics, coding and documentation process and educational improvements • Conduct new provider orientations and ongoing education to provider and their staff on healthcare delivery products, health plan partnerships, processes, and tools • Use and analyze data to identify trends, patterns and opportunities for the business and clients, and collaborating and/or participating in discussions with colleagues and business partners to identify potential root cause of issues • Conduct provider meetings to share and discuss reporting data and analysis, issue resolution needs, implement escalation processes for discrepancies, and manages or ensures appropriate scheduling, agenda, and materials • Collaborates with internal clinical services teams, alongside operational leaders' leaders, to monitor utilization trends to assist with developing strategic plans to improve performance • Assists provider groups with investigating standard and non-standard requests and problems, to include claims and member support services • Maintains effective support services by collaborating effectively with the medical director, operations, and cross functional teams, and other departments • Demonstrate understanding of providers' business goals and strategies to facilitate the analysis and resolution of their issues • Performs all other related duties as assigned 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 succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • 3+ years of experience in a related medical field or health plan setting (network management, contracting and/or recruitment, or provider relations) • Knowledge of state and federal laws relating to Medicare • Solid working knowledge of Medicare health care operations including HEDIS, CMS reimbursement models, and Medicare Advantage • Understanding of IPAs, Clinically Integrated Networks, Medicare Shared Savings Programs, capitation/value-based contracting, and narrow networks • Proficiency in Microsoft Word, Excel, and PowerPoint • Ability to travel 25% of the time • Driver's License and access to reliable transportation Preferred Qualifications: • Proven solid business acumen, analytical, critical thinking, and persuasion skills • Demonstrated ability to function as a mentor to others • Demonstrated ability to develop long-term positive working relationships • Demonstrated ability to communicate and facilitate strategic meetings with groups of all sizes • Demonstrated ability to work independently, use good judgment and decision-making process • Demonstrated ability to conduct performance evaluation to identify performance measures or indicators and the actions needed to improve or correct performance, relative to the goals • Demonstrated ability to resolve complete problems and evaluate options to implement solutions • Demonstrated ability to adopt quickly to change in an ever-changing environment • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Manage provider networks by analyzing performance data, educating providers on quality and cost goals, driving process improvements, and collaborating with clinical and operational teams. | Requires 4+ years related experience including 3+ years in healthcare or health plan setting, knowledge of Medicare laws and operations, proficiency in Microsoft Office, and ability to travel 25%. | For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. The Account Manager has geographic responsibility for the quality and economic performance of the physician practice with the goal of developing a high performing provider network within the State of Kansas and Missouri. This includes analyzing, reviewing, forecasting, trending, and presenting information for operational and business planning. The Account Manager will develop and sustain a solid day-to-day relationship with stakeholders, the physician and office staff to effectively implement the business solutions developed by the Client Services leadership team. The Account Manager is accountable for overall performance and profitability for their assigned groups as well as ownership and oversight to provide redirection as appropriate and approved. The responsibilities of this position include capabilities in the following areas: strategic planning and analysis; understanding of HEDIS, Star ratings, accurate documentation, and coding; advanced communication skills; and the ability to develop clear action plans and drive process. If you are located in Southeast Kansas, you will have the flexibility to work remotely* as you take on some tough challenges. Essential Job Functions • Educate providers to ensure they have the tools needed to meet quality, coding and documentation, and total medical cost goals per business development plans • Develops strategies and create action plans that align provider pools and groups with company initiatives, goals, quality outcomes, program incentives, and patient care best practices • Drive processes and improvement initiatives that directly impact revenue, HEDIS/STAR measures and quality metrics, coding and documentation process and educational improvements • Conduct new provider orientations and ongoing education to provider and their staff on healthcare delivery products, health plan partnerships, processes, and tools • Use and analyze data to identify trends, patterns and opportunities for the business and clients, and collaborating and/or participating in discussions with colleagues and business partners to identify potential root cause of issues • Conduct provider meetings to share and discuss reporting data and analysis, issue resolution needs, implement escalation processes for discrepancies, and manages or ensures appropriate scheduling, agenda, and materials • Collaborates with internal clinical services teams, alongside operational leaders' leaders, to monitor utilization trends to assist with developing strategic plans to improve performance • Assists provider groups with investigating standard and non-standard requests and problems, to include claims and member support services • Maintains effective support services by collaborating effectively with the medical director, operations, and cross functional teams, and other departments • Demonstrate understanding of providers' business goals and strategies to facilitate the analysis and resolution of their issues • Performs all other related duties as assigned Primary Responsibilities • Solid analytical skills required to support, compile, and report key information • Drive processes that directly impact Revenue, HEDIS/STAR measures and Quality Metrics, and total cost of care, as appropriate • Use data to identify trends, patterns and opportunities for the business and clients. Develop business strategies in line with company strategic initiatives • Engage provider staff and providers in analysis and evaluation of functional models and process improvements; identify dependencies and priorities • Evaluate and drive processes, provider relationships and implementation plans • Produce, publish, and distribute scheduled and ad-hoc client and operational reports relating to the performance of related metrics and goals • Collaborate with internal leaders to foster teamwork and build consistency throughout the market • Serves as a liaison to the health plan and all customers • Requires solid presentation skills, problem solving and ability to manage conflict and identify resolutions quickly • Have the ability to communicate well with physicians, staff, and internal departments 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 succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications • 4+ years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelor's degree • 3+ years of experience in a related medical field or health plan setting (network management, contracting and/or recruitment, or provider relations) • Knowledge of state and federal laws relating to Medicare • Solid working knowledge of Medicare health care operations including HEDIS, CMS reimbursement models, and Medicare Advantage • Understanding of IPAs, Clinically Integrated Networks, Medicare Shared Savings Programs, capitation/value-based contracting, and narrow networks • Proficiency in Microsoft Word, Excel, and PowerPoint • Ability to travel 25% of the time • Valid driver's License and access to reliable transportation Preferred Qualifications • 5+ years of in a healthcare related field • Demonstrated ability to function as a mentor to others • Demonstrated ability to develop long-term positive working relationships • Demonstrated ability to communicate and facilitate strategic meetings with groups of all sizes • Demonstrated ability to work independently, use good judgment and decision-making process • Demonstrated ability to conduct performance evaluation to identify performance measures or indicators and the actions needed to improve or correct performance, relative to the goals • Demonstrated ability to resolve complete problems and evaluate options to implement solutions • Demonstrated ability to adopt quickly to change in an ever-changing environment • Proven solid business acumen, analytical, critical thinking, and persuasion skills • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Lead pharmacy strategy and account management to drive growth, retention, and profitability for OptumRx integrated pharmacy clients, collaborating with internal teams and external stakeholders. | Requires 5+ years account management experience with client retention and sales success, proficiency in Microsoft Suite, willingness to travel up to 25%, and preferably 5+ years in PBM/RX industry with pharmacy financial knowledge. | Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. If you are located in Eastern / Central Time Zone, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities • Provide strategic planning, direction and leadership in direct support of UnitedHealthcare Employer & Individual integrated medical & pharmacy growth and retention initiatives for existing OptumRx integrated accounts as well as certain standalone pharmacy clients where UnitedHealthcare Employer & Individual segments have an existing or targeted relationship • Take lead role in pharmacy strategy development for existing OptumRx integrated pharmacy clients to achieve retention, profitability and satisfaction objectives as set by UnitedHealthcare • Organize internal resources as necessary to support pharmacy growth and retention for existing clients including engaging OptumRx and UnitedHealthcare Leadership for complex competitive renewals • Collaborate with Strategic Account Executives and OptumRx Directors to define customer needs to enable company to differentiate and position for growth and retention • Understand the competitive landscape and effectively position pharmacy management programs, participating as account management lead for pharmacy in best and final meetings, industry forums, broker and consultant meetings • Work closely with the Strategic Account Executives, OptumRx Directors, the health plan leadership and assigned region to provide OptumRx subject matter expertise and support in achieving desired growth and retention results • Deliver integrated pharmacy value proposition and related training, program updates for UHCE&I leadership, account management teams, and matrix partners including underwriting and other operational partners as needed • Implements effective pharmacy strategy and goals which are aligned with and supportive of those of the company and our customers. Networking, collaboration and consensus building - uses internal networks to get things done; utilizes assistance of others who have a stake in the outcome and proactively • participates in achieving customer satisfaction and service performance in a continually changing environment • Possess a thorough understanding of the commercial healthcare marketplace and key sales drivers in order to align our pharmacy value proposition to solve their key business challenges • Channel customer needs and expectations into the larger organization's priorities initiatives and services • Strategic Vision - Understands and communicates the company's long term and short-term value proposition to achieve the desired goals of pharmacy management • Effectively expresses ideas and information in writing and orally to individuals and groups at all levels using two-way communication and a high impact communication style • Demonstrates skill in organizing, leading and inspiring individuals toward pursuit of customer satisfaction in a rapidly changing environment. Drives disciplined, fact-based decisions • Drives change and innovation through continually seeking and implementing innovative solutions; thrives on continuous change; inspires people to stretch beyond their comfort zone, takes well-reasoned risks on 'what has always been done' and change direction, as required • Model and demand integrity and regulatory compliance • Execute with discipline and urgency; drive exceptional performance; deliver value to the customer; get directly involved when needed; actively manage financial performance; ensure accountability for results 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 succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications • 5+ years of experience with account management team ensuring that existing clients are satisfied with and recognize the value of the solutions they currently use and as a result renew their existing relationships and actively engage in discussions regarding the use of additional solutions • Experience and proven ability to retain and sell business • Proficiency with Microsoft Suite of products • Willingness to travel as required up to 25% • Driver's License and access to a reliable transportation Preferred Qualifications • 5+ years of account management/sales experience in the PBM/RX industry • 5 + years of experience working with understanding of pharmacy financials and pricing coupled with the ability to negotiate using the data • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $110,200 to $188,800 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Lead and coach a team of Healthcare Service Representatives to meet contact center performance goals, manage resource planning, and ensure policy compliance. | 2+ years supervisory experience in a contact center, 1+ year team lead experience at Kelsey-Seybold, proficiency with Microsoft Office and contact center technologies. | Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. The Contact Center Supervisor I (CCS I) provides leadership, coaching, development and support to their team of Healthcare Service Representatives (HSRs) to attain Contact Center service and performance goals. If you are located in Texas, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: • This position is responsible for identifying training and performance needs, monitoring phone and work queue performance, developing action plans for improving and sustaining team performance as well as participating and completing special projects as assigned • The Supervisor I partners with the Workforce Management Team to ensure effective resource planning to maximize productivity of their team • The CCS I works closely with clinic partners and serves as an escalation point for providers and clinical staff • The CCS I position is responsible for ensuring that Corporate and Contact Center policies are followed as well as helping to identify and execute changes in policy and procedures • The CCS I is expected to set the example of living the Kelsey-Seybold values of quality and care 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 succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • 2+ years of equivalent work experience • 2+ years of supervisory experience in a contact center environment (or equivalent experience) • 1+ years of experience as a Team Lead or Coordinator in Kelsey-Seybold Contact Center • Experience using Microsoft Excel, Microsoft Power Point, Microsoft Word • Proven knowledge and experience with Contact Center technologies including Call Routing and Workforce Management systems Preferred Qualifications: • 3+ years of supervisory experience in a Health care related contact center or 1+ years of supervisory experience in Kelsey-Seybold Contact Center • Experience and knowledge of Cisco • Experience and knowledge of Calabrio Workforce Management system • Fluent in conversational Spanish • All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $48,700 to $87,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.