UnitedHealthcare

Developing and maintaining cloud-based services, APIs, and full-stack applications with a focus on healthcare solutions. | Requires extensive experience with JavaScript frameworks, cloud services, and API development, with additional skills in SQL and Python. | At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. We are seeking a skilled Software Engineer to join our team. You will contribute to the development and operation of cloud-based services, ensuring high-quality, scalable code with comprehensive testing and documentation. Your role includes collaborating with other teams to resolve issues and drive innovation. If you are passionate about continuous improvement and innovation, we want to hear from you. This role will see you working across our product suite, contributing to the design, development, and delivery of innovative software. You'll work with C# (.Net Core), SQL, Python, HTML/CSS, JavaScript frameworks, Azure Stack, collaborating with product owners, data and software engineers to deliver impactful solutions. Who You'll Be: You'll be an experienced software engineer who takes pride in delivering high-quality solutions, approaches challenges with curiosity and initiative, and thrives working both independently and in collaborative teams to solve real-world problems through technology. What you'll do: We believe in the power of technology to allow us to work more efficiently. As part of the LOGIC technology team, you'll play a key role in helping us deliver innovative products that support healthcare professionals in making informed decisions. You will need to be ambitious, detail-oriented, technically solid, willing to work out of your comfort zone, and eager to learn. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. Primary Responsibilities: • Design, develop, test, and maintain high quality software solutions • Write clean, scalable, and reusable code with appropriate unit and automated tests • Participate in code reviews and follow best practices, patterns, and coding standards • Collaborate with product owners and cross functional teams to translate requirements into technical solutions • Develop and maintain APIs, backend services, and full stack application • Troubleshoot, debug, and resolve production issues to minimize downtime • Contribute to software architecture decisions ensuring scalability, security, and maintainability • Support CI/CD processes, DevOps practices, and automated deployment workflows • Create and maintain technical documentation • Continuously evaluate and recommend new tools, technologies, and process improvements • Prioritize tasks effectively and provide accurate development estimates • Understand user needs and ensure solutions deliver an optimal customer experience • Maintain data integrity, quality, and reliability across systems • Engage in ongoing learning to stay current with emerging technologies and industry trends • Collaborate to improve development workflows and engineering quality • Working with technologies such as Python and SQL • Build and maintain C#/.Net application using best practices and design patterns • Optimizing application performance and conducting self-code reviews • Participate in design and code reviews to ensure that developed code meets software engineering best practices and guidelines, security, and scalability and maintainability guidelines • Offer support by responding to system problems in a timely manner • Design & develop reusable components, patterns, and frameworks, encouraging innovation that will enable team velocity 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: • Bachelor's degree or higher in Computer Science, Information Technology, Engineering, or related field • 4+ years of experience with MS SQL Server, Oracle, and Snowflake • 4+ years of experience and proficiency of front end skills: HTML5, CSS3, JavaScript, and JavaScript frameworks • 3+ years of hands on experience with C#, .NET Core, MVC • 3+ years of professional software development in scalable, secure, cloud native systems • 3+ years of experience with Microsoft Azure cloud services and cloud based deployments • 3+ years developing RESTful APIs; solid understanding of web services and microservices • 2+ years working with Python • Experience with SDLC, including testing phases and full lifecycle delivery • Experience building modular, testable, reusable software components • Experience working with stakeholders across requirements, approvals, UAT, and post release support • Familiarity with API development, streaming technologies, Kafka, and Event Hubs • Solid understanding of DevOps, CI/CD, Git/GitHub, and infrastructure automation • Knowledge of integration technologies, middleware, and identity/Active Directory models • Proficiency in SQL, including writing and optimizing queries and stored procedures (MSSQL, T SQL, PLSQL) • Proven solid problem solving and analytical abilities, solid attention to detail • Proven excellent communication and interpersonal skills • Proven organizational and time management skills • Demonstrated ownership, accountability, and collaborative mindset • Demonstrated ability to understand complex problems and deliver high quality solutions • Demonstrated ability to collaborate effectively to meet deadlines and deliver product updates • Demonstrated cultural alignment: integrity, compassion, inclusion, relationships, innovation, performance Preferred Qualifications: • 2+ years of modernizing legacy systems • Experience with messaging and stream processing on messaging technologies • SignalR or Similar Technology • Hands-on experience in building charts, graphs and visuals with SSRS/PowerBI • Background and experience with metrics reporting • Automated testing experience • Experience with State Medicaid / Medicare / Healthcare • Experience with automated provisioning tools and workflows • Experience designing, creating, and securing APIs; OAuth, JWT, WS-Security, SAML • Knowledge and experience working with Docker, Kubernetes • Knowledge of SharePoint • Familiarity with healthcare workflows • Demonstrated understanding of data modeling • Proven solid knowledge of data structures, algorithms, distributed systems, and asynchronous architecture • Proven excellent Team Player showcasing independence and ownership • Demonstrated ability to change and adapt quickly Telecommuting Requirements: • Ability to keep all company sensitive documents secure (if applicable) • Required to have a dedicated work area established that is separated from other living areas and provides information privacy • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service • 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 $72,800 to $130,000 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.

Leading and managing AI conversational design teams to develop and maintain high-quality AI experiences, establishing standards, and influencing AI tooling and processes. | Over 6 years of experience in designing complex conversational AI experiences, with leadership experience in managing teams and influencing stakeholders, and familiarity with AI frameworks and prompt engineering. | 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. As an Associate Director of Conversational AI Design, you will lead a talented team of designers shaping the future of human-AI interaction. In this role, you'll own a diverse portfolio and partner closely with product and engineering teams to push the boundaries of AI experiences that deliver meaningful value. You'll be responsible for the delivery and design excellence across conversational experiences by coaching your team on evolving AI processes, standards and business goals. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. Primary Responsibilities: • Strategic Leadership • Collaborate with senior stakeholders and cross-functional leaders to advocate for AI design excellence and align on priorities • Establish processes to measure conversation effectiveness, identify opportunities for improvement and quantify business impact • Deliver effective, short-term solutions with strategic foresight to push for long-term, industry-leading experiences • People Leadership • Manage and mentor a high-performing team of AI designers, fostering a culture of career growth and delivery excellence • Implement structured mentoring and capacity planning to strengthen organization design impact • Guide the team through ambiguity, ensuring clarity, alignment and effective execution across initiatives • Attracts and mentors junior employees to contribute to retention and development • Delivery & AI Innovation • Establish and maintain conversational AI design standards to ensure consistency and quality • Influence and define AI tooling solutions, scalable design processes and prompt engineering best practices to improve quality and efficiency 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: • 6+ years of hands-on experience designing highly complex chat and voice conversational experiences • 1+ years of building, maintaining and strengthening direct report teams with reliable and consistent high performance • Experience leading a design portfolio, including managing the delivery roadmap and long-term vision • Digital portfolio or work samples of relevant AI/conversational projects (to be submitted with application and presented in the hiring process) • Proven ability to influence leadership and stakeholders through communication and content • Proven to be highly skilled at driving team clarity in ambiguous, fast-paced environments to ensure consistency across voice, tone and brand standards • Demonstrated ability leading AI-driven experiences including knowledge of LLMs, bot platforms and prompt engineering best practices • Comfort and ability to travel occasionally to UHC worksites Preferred Qualifications: • Experience leading teams through transformation, such as adoption of new AI tools, processes or AI augmented workflows • Experience defining and maintaining enterprise-level scalable frameworks and conversational design patterns • Experience utilizing AI frameworks to evaluate conversation performance for continuous improvement • Experience working in a clinical, healthcare or health insurance setting • Knowledge of ethical AI standards including bias, fairness and transparency • 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 $112,700 to $193,200 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. #UHCPJ 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.

Provide strategic consultative services and actionable insights to employer groups by analyzing health plan performance and collaborating with internal teams. | Bachelor's degree, 2+ years customer-facing consulting or sales experience, healthcare knowledge, strong presentation and Excel/PowerPoint skills, ability to travel. | At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Consultant provides year-round strategic consultative services with an integrated focus on the UnitedHealthcare Value Story by diving deep into the analytics of health plan performance to further support UnitedHealth Group's position as a trusted advisor and carrier of choice. If you are located in New York or New Jersey you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities • This role is part of a dedicated strategic team that supports complex employer groups within Local Markets, generally within a geographic region • Consultants will create compelling, client-specific insights and content for a variety of client engagements • Consultants will present a portion of client engagements as determined by the Strategist based on client needs (internal/external), resource availability and development opportunity • Consultant will focus on insights and storytelling. Distillation of compelling and/or actionable insights from data and reporting is required • Navigation of data, tools, and related resources will be necessary for success in telling a story with actionable insight • Distillation of compelling and/or actionable insights from data and reporting is required • Consultants will focus on insights and storytelling • In-depth knowledge of adopted and proposed client solutions • Collaborate with market strategic team members as needed • Provide colleague feedback to all participants in the market strategic team to support leadership goals around talent assessment, career planning, and growth opportunities • Will have no direct reports • Collaborate with the broader Account Management Team (AMTs) and other internal business partners to solve complex customer analytic needs and serve as a strategic analytic subject matter expert • Communicates information openly and in an articulate and professional manner as a strategic consultative subject matter expert 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 • Bachelor's degree • 2+ years in a customer-facing role, preferably within a sales, account management, TPA, or consulting environment • Demonstrated knowledge of healthcare cost and quality topics, as well as the ability to speak to emerging industry trends • Proven intermediate or higher skills within Office 365 applications, particularly Excel and PowerPoint • Demonstrated presentation skills, preferably with a director-level and higher audience • Driver's license and access to reliable transportation • Ability to travel up to 25% of the time depending on customer needs Preferred Qualifications • Experience in data analytics, data science, statistics or underwriting • Clear and concise written & verbal communication skills; successful virtual presentation experience • 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. 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.

Respond to provider inquiries via call and chat, troubleshoot and resolve issues, document interactions, collaborate with teams, stay updated on policies, and maintain compliance. | At least 2 years of customer service experience, strong communication skills, computer proficiency, problem-solving abilities, and ability to work independently remotely. | Job Title: Provider Customer Service Call and Chat Representative Company Overview: UnitedHealthcare is a leading health benefits company dedicated to improving the health and well-being of individuals and communities. With a commitment to innovation and quality care, we strive to simplify the healthcare experience for our members and providers alike. Role Overview: As a Provider Customer Service Call and Chat Representative, you will play a vital role in supporting healthcare providers by addressing their inquiries and resolving issues efficiently. This remote position offers the flexibility to work from home within North Carolina while contributing to a seamless healthcare experience. What You'll Do: - You will respond promptly to provider inquiries via call and chat, ensuring clear and professional communication. - You will troubleshoot and resolve provider issues related to claims, benefits, and eligibility. - You will document all interactions accurately in the system to maintain up-to-date records. - You will collaborate with internal teams to escalate and resolve complex provider concerns. - You will stay informed about policy changes and updates to provide accurate information. - You will contribute to process improvements by sharing feedback and insights from provider interactions. - You will maintain compliance with company policies and regulatory requirements. What You Bring: - You bring at least 2 years of customer service experience, preferably in healthcare or insurance. - You have strong communication skills, both verbal and written, with the ability to handle difficult conversations. - You possess basic computer proficiency and experience with call center software or CRM systems. - You demonstrate problem-solving skills and attention to detail. - You are self-motivated and able to work independently in a remote environment. Bonus Points If You Have: - Experience working in a healthcare provider services or insurance claims environment. - Familiarity with UnitedHealthcare products and services. - Bilingual skills, especially in Spanish. - Previous remote work experience. What We Offer: - We offer competitive salary and comprehensive benefits including health, dental, and vision coverage. - We offer flexible remote work arrangements to support work-life balance. - We offer opportunities for professional development and career growth. - We offer a supportive and inclusive company culture focused on employee well-being. - We offer paid time off and wellness programs. Ready to Apply? To join our team as a Provider Customer Service Call and Chat Representative, please submit your resume and cover letter through our careers portal at UnitedHealthcare.com/careers. We look forward to hearing from you!

Respond to provider inquiries via phone and chat, resolve claims and authorization issues, document interactions, collaborate with teams, and maintain knowledge of policies. | At least 2 years of customer service experience, strong communication and computer skills, ability to multitask and work remotely, with healthcare or insurance experience preferred. | Job Title: Provider Customer Service Call and Chat Representative Company Overview: UnitedHealthcare is a leading health benefits company dedicated to improving the health and well-being of individuals and communities. With a commitment to innovation and quality care, we strive to simplify the healthcare experience for our members and providers alike. Role Overview: As a Provider Customer Service Call and Chat Representative, you will play a crucial role in supporting healthcare providers by addressing their inquiries and resolving issues efficiently. This remote position offers flexibility while allowing you to contribute to the mission of enhancing healthcare access and quality. What You'll Do: - You will respond to provider inquiries via phone and chat, delivering timely and accurate information. - You will troubleshoot and resolve issues related to claims, authorizations, and provider accounts. - You will document all interactions thoroughly to ensure clear communication and follow-up. - You will collaborate with internal teams to escalate and resolve complex provider concerns. - You will maintain up-to-date knowledge of UnitedHealthcare policies, procedures, and systems. - You will contribute to process improvements by providing feedback based on provider interactions. - You will uphold high standards of customer service, demonstrating empathy and professionalism. What You Bring: - You have at least 2 years of experience in customer service, preferably in healthcare or insurance. - You possess strong communication skills, both verbal and written. - You are proficient with computer systems and comfortable navigating multiple software applications. - You have the ability to manage multiple tasks and prioritize effectively in a remote work environment. - You demonstrate problem-solving skills and attention to detail. Bonus Points If You Have: - Experience working with healthcare providers or in a health insurance setting. - Familiarity with claims processing and authorization procedures. - Previous remote work experience with self-motivation and discipline. - Bilingual abilities, especially in Spanish. What We Offer: - We offer a flexible remote work arrangement within North Carolina. - We offer comprehensive health benefits including medical, dental, and vision coverage. - We offer opportunities for professional development and career growth. - We offer a supportive and inclusive work culture focused on employee well-being. - We offer competitive compensation and performance-based incentives. Ready to Apply? Submit your application through the UnitedHealthcare careers portal with your updated resume and cover letter highlighting your relevant experience and interest in the role.

Review and enter HCBS authorizations, communicate with providers, gather clinical information, and consult with care managers to expedite care. | Active unrestricted RN license, 3+ years acute care experience, proficiency with Microsoft Office, and ability to work remotely if in Virginia. | At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. What makes your nursing career greater with UnitedHealth Group? You can improve the health of others and help heal the health care system. You will work within an incredible team culture; a clinical and business collaboration that is learning and evolving every day. And, when you contribute, you'll open doors for yourself that simply do not exist in any other organization, anywhere. If you reside within the state of Virginia, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities • Authorization review and entry for HCBS authorizations using Virginia specific criteria • Review of state specific documents required for HCBS services • Communication with HCBS Providers • Gather clinical information to assess and expedite care needs • Consult with the Care Manager and/or Medical Director as needed to troubleshoot difficult or complex cases 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 • Unrestricted, active RN license • 3+ years of RN experience in an acute setting • Ability to create, edit, save and send documents utilizing Microsoft Word. Ability to navigate a Windows environment, Microsoft Outlook, and conduct Internet searches Preferred Qualifications • HCBS authorization experience • Utilization management, prior authorization, and case management experience • Managed care experience • Working knowledge of ICUE and CAT_LaunchPad • 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.

Lead and manage community partnership programs, develop strategies aligned with state goals, oversee budgets, ensure compliance, and collaborate with multiple stakeholders to improve health and social outcomes. | Requires 5+ years leadership and project management experience, proficiency in Excel, collaboration across disciplines, strong communication with regulators, Florida residency, and 50% travel. | At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. Must be a FL resident. Associate Director of Community Partnerships, reporting to the COO, this position is responsible for three critical programs of the contract. Prioritizing Community Partnerships to Improve Outcomes (CPIO) requires the establishment and maintenance of partnerships with community-based organizations (CBOs) focused on creating opportunities to assist members experiencing barriers or challenges in over-coming health related social needs (HRSN) such as housing instability, food insecurities, unemployment, academic and vocational training support, etc. Examples of CBOs include public or private, non-governmental, for-profit or non-profit organizations with demonstrated effectiveness in Florida. Efforts of this work focus on 6 priority areas, Improving Birth Outcomes, Improving Resiliency and Mental Health of Children and Adolescents, Improving Chronic Disease Management, Improving Economic Self-Sufficiency, Serious Mental Illness and HIV/AIDS. Functions Of The CPIO Work Include • Develop a community-based strategy that aligns to Florida's Agency for Health Care Administration goals. • The development and maintenance of an adequate network of CBOs in each region, with on-site visits expected throughout the course of the partnership with the CBO • Oversight and plan-wide coordination of an agency approved assessment tool • Development of policies and procedures for referring members to CBOs • Collaboration with the CBOs on quality improvement initiatives to address HRSNs • Lead a plan-wide committee, required by NCQA Accreditation on the CPIOs • Manage all budgetary functions, in partnership with CFO, for the provision of monetary support or in-kind donation of goods and services to the CBOs • Ensure a "closed-loop" in member record, documenting receipt of services for the member • Manage all aspects of the annual CPIO report to the agency in a manner and format specified by the agency - including but not limited to a detailed description of the collaboration, an evaluation of the impact on member outcomes and the amount of monetary support and in-kind donations • Document programs and interventions, and support measurement and monitoring of program effectiveness • Incorporate applicable accreditation, regulatory, and business requirements into programs and projects • Monitor performance over time against established performance goals; identify opportunities for improvement (i.e., geographic, demographic) If you reside in Florida, you will have the flexibility to work remotely* as you take on some tough challenges. Hope Florida is an initiative that aims to help Floridians overcome barriers to economic self-sufficiency. This position will: • Lead Program Governance and Management • Develop meaningful partnerships with CBOs who can assist with long-term resolution of transportation and childcare challenges • Receive and manage referrals from Hope Navigators, meeting timeliness of the referral as defined by the contract • Provide detailed reporting requirements to the agency • Note: failure to comply may result in sanctions or liquidated damages The role is equally responsible for the Self-Sufficiency Achievement Requirements and Self-Sufficiency Incentive of the contract, demonstrating success in assisting members in achieving economic self-sufficiency that results in graduation from the Medicaid program. This Position Will • Define and establish a strategy that supports member movement towards self-sufficiency • Initiate, plan, execute, monitor and control all aspects of our Hope Florida Plan • Develop complete identification of the assessment utilized to determine barriers • Build descriptions of barriers • Provide a description of the expanded benefits provided to the members • Validate referrals made to the CBOs • Confirm "closed loop" using system used by the plan • Track the number of members who have gained employment or better wages 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 leadership experience • 5+ years of project management experience • Intermediate to advanced experience utilizing Excel • Experience in collaborating across multiple disciplines (LTC, OBH, fiscal, legal, compliance, among others) • Proficient with verbal and written communication specifically with state regulators and partners • Proven critical thinking skills: the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action • Must be a FL resident • 50% Travel required Preferred Qualifications • 5+ years of community-based organization or healthcare setting • Masters level degree • Demonstrated ability to assist with focusing activities on a strategic direction as well as developing tactical plans, drive performance, and achieving targets as described in all three components of this position • Proven ability to influence, interact, and negotiate with community organizations, peers, leaders and internal company staff at all levels If the hired individual resides in Florida (office based or telecommuting) this position requires the AHCA Level II background check (fingerprinting) by the State of Florida for all clinicians that have direct face to face contact with members OR employees who will have access to confidential patient data and will require renewal every five years. • 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. 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 and evaluate clinical appeals and grievances, coordinate with Medical Director, and document determinations while working remotely with weekend and overtime requirements. | Active RN license, 2+ years clinical inpatient experience, proficiency with Microsoft Office, availability for weekend and overtime work, preferred experience with MCG/Medicare criteria and utilization management. | At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Clinical Appeals RN is responsible for providing expertise in clinical appeals and grievances (analyzing, reviewing, and evaluating appeals and grievances), and acting as a Clinical Interface Liaison (clinical problem solver with facilities, providers, carriers, resolution of issues concerning members, benefits, program definition and clarification). You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. This role will work weekends, usually every other week or every week if working a 4 day work week. 5 day work week schedules are also availilbe. Primary Responsibilities • Review medical records and verify if the requested service meets criteria • Review pre-service appeals for clinical eligibility for coverage as prescribed by the Plan benefits • Review and interpret Plan language • Coordinate reviews with the Medical Director • Utilize clinical guidelines and criteria • Accurately documenting determinations • Adherence to all confidentiality regulations and agreements • Hours M-F 8a-5p with alternating Saturdays • Comfortable working mandatory overtime 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 • 2+ years of clinical experience as an RN, including in an acute, inpatient hospital setting • Proficiency in Microsoft Office, Word, Outlook, and Internet applications • Available for 5 day work weeks including weekdays and weekends, 8:00- 4:30 in their time zone and some weekend work will be needed Preferred Qualifications • Bachelor of Science in Nursing • 1+ years of experience using MCG and/or Medicare criteria • 1+ years of Utilization Management, pre-authorization, concurrent review or appeals experience • Appeals experience • Proven excellent communication, interpersonal, problem-solving, and analytical 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 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. 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 care coordination for members with complex medical and behavioral needs through assessments, care planning, collaboration, education, and discharge planning. | Requires current Colorado RN license, 2+ years clinical experience, MS Office proficiency, ability to travel locally, and residency in Colorado. | At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. Doing the right thing is a way of life at Rocky Mountain Health Plans (RMHP). As part of the UnitedHealthcare family of plans, RMHP provides innovative health insurance coverage and personalized attention to individuals of all ages and business of all sizes throughout Western and rural Colorado. RMHP is continually striving to improve the health and wellness of our Members and partners in the state where we live, work, and play - because we're Colorado, too. The RN Behavioral Health Clinical Care Coordinator will be the primary care manager for a panel of members with complex medical/behavioral needs. Care coordination activities will focus on supporting member's medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care. If you reside locally to Archuleta, La Plata, Dolores or Montezuma Counties, CO, you will have the flexibility to work remotely* while taking on some tough challenges. Primary Responsibilities: • Engage members and/or their families face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs • Develop and implement individualized, person-centered care plans inclusive of goals, opportunities and interventions aligned with a person's readiness to change to support the best health and quality of life outcomes by meeting the member where they are • Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan • Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health • Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission • Advocate for members and families as needed to ensure the member's needs and choices are fully represented and supported by the health care team 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: • Current, unrestricted independent licensure as a Registered Nurse in Colorado • 2+ years of clinical experience • 1+ years of experience with MS Office, including Word, Excel, and Outlook • Driver's License and access to reliable transportation • Ability to travel up to 25% of the time within SW Colorado (Archuleta, La Plata, Dolores, Montezuma) to meet with members and providers • Resdient of Colorado Preferred Qualifications: • BSN, master's degree or higher in clinical field • CCM certification • 1+ years of community case management experience coordinating care for individuals with complex needs • Behavioral health experience • Experience working in team-based care • Background in Managed Care 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 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.

Provide clinical support and navigation assistance to members including appeals, care coordination, and education while working remotely. | Must have current RN license, 2+ years acute, behavioral health, and Medicaid waiver nursing experience, and ability to work independently with computer skills. | At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Special Needs Senior Clinical Admin Nurse will be responsible for providing individualized attention to UMR membership and covered families and serves to assist with navigation of the health care system. The purpose of the clinical liaison nurse is to help individuals live their lives to the fullest by supporting coordination and collaboration with multiple and external partners including consumers and their families/caregivers, medical, and other clinical teams. Candidate must be willing to work Monday - Friday 8:00 am - 5:00 pm You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities • Provide members with tools and educational support needed to navigate the health care system and manage their health concerns effectively and cost efficiently • Assist members with adverse determinations, including the appeal process • Teach members how to navigate UMR internet-based wellness tools and resources • Outreach to membership providing pre-admission counseling to membership • Outreach to membership providing discharge planning to membership and caretakers • Track all activities and provide complete documentation to generate customer reporting • Accept referrals via designated processes, collaborate in evaluating available services, and coordinate necessary medical care and community referrals as needed • Comply with all policies, procedures and documentation standards in appropriate systems, tracking mechanisms and databases • Contribute to treatment plan discussions • Other 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 • Current and unrestricted RN compact license • Ability to obtain additional licenses as required • 2+ years of acute nursing experience • 2+ years of behavioral health nursing experience • 2+ years of Medicaid waiver experience • Demonstrated basic computer proficiency (i.e. MS Word, Outlook) • Proven ability to function independently and responsibly with minimal supervision Preferred Qualifications • Bachelor's degree in nursing • CCM • 2+ years of managed care experience • 2+ years of case management experience • Critical care, pediatric, med-surg and/or telemetry experience • Utilization management experience • Adverse determination experience • Telecommute experience Soft Skills • Demonstrated excellent verbal and written communication skills • Excellent customer service orientation • Proven team player and team building skills • Ability and flexibility to assume responsibilities and tasks in a constantly changing work 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. 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.

Conduct clinical reviews and authorizations for LTSS and HCBS services ensuring medically necessary, cost-effective care while collaborating with interdisciplinary teams. | Active Michigan RN license, 3+ years clinical experience, 1+ year in LTSS/HCBS or managed care, knowledge of Medicaid and clinical documentation systems. | At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Utilization Management Nurse is responsible for conducting clinical reviews and authorizations for LTSS and HCBS services. This role ensures that members receive medically necessary, cost-effective, and person-centered care in the least restrictive environment. The nurse collaborates with interdisciplinary teams, care managers, and providers to support member goals and improve health outcomes. If you reside in Michigan, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities • Review and process prior authorization requests for LTSS and HCBS services including Personal Care Services (PCS), Home and Environmental Modifications and others • Apply clinical judgment and decision support tools to determine medical necessity and appropriateness of services. • Participate in secondary reviews for complex cases, including transitions between community and institutional settings. • Collaborate with care managers, physicians, and other stakeholders to ensure continuity of care and alignment with the member’s service plan. • Monitor utilization patterns and identify opportunities for improved care coordination and cost containment. • Document all clinical decisions and communications in accordance with regulatory and organizational standards. • Stay current with federal and state regulations, including 42 CFR Part 456 and CMS guidelines for HCBS and LTSS. • Support quality improvement initiatives and participate in audits and compliance reviews. • Participate in annual Inter-Rater Reliability testing and pass with a score of 90% or higher • Appropriately identifies the need for secondary reviews or case consultations with the Medical Director • Documents concise case reviews • Apply relevant regulatory requirements to ensure compliance with clinical documentation. • Identify potential quality of care concerns, including instances of over/or underutilization of services and escalate these issues as needed. • Participate in state or plan-required audits and comply with all reporting requirements by area of responsibility 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 and unrestricted RN license in the state of Michigan • 3+ years of clinical experience • 1+ years of experience in LTSS, HCBS, or managed care • Solid knowledge of Medicaid programs, HCBS waiver services, and person-centered planning • Proficiency in clinical documentation systems and utilization management platforms (e.g., ICUE, Community Care, OCM) • Proven excellent communication, critical thinking, and organizational skills • Must reside in Michigan Preferred Qualifications • Certified Case Manager (CCM) • Utilization Management certification • Experience with D-SNP or similar Medicaid managed care programs • Familiarity with risk stratification tools and interdisciplinary care planning • Demonstrated ability to work independently and manage multiple priorities in a fast-paced 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. 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.

Coordinate care for members with complex medical and behavioral needs through assessments, care plans, collaboration, education, and discharge planning. | Requires current Colorado RN license, 2+ years clinical experience, MS Office skills, driver's license, and ability to travel locally. | At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. Doing the right thing is a way of life at Rocky Mountain Health Plans (RMHP). As part of the UnitedHealthcare family of plans, RMHP provides innovative health insurance coverage and personalized attention to individuals of all ages and business of all sizes throughout Western and rural Colorado. RMHP is continually striving to improve the health and wellness of our Members and partners in the state where we live, work, and play - because we're Colorado, too. The RN Behavioral Health Clinical Care Coordinator will be the primary care manager for a panel of members with complex medical/behavioral needs. Care coordination activities will focus on supporting member's medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care. If you reside locally to Archuleta, La Plata, Dolores or Montezuma Counties, CO, you will have the flexibility to work remotely* while taking on some tough challenges. Primary Responsibilities • Engage members and/or their families face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic (SDoH) needs • Develop and implement individualized, person-centered care plans inclusive of goals, opportunities and interventions aligned with a person's readiness to change to support the best health and quality of life outcomes by meeting the member where they are • Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan • Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health • Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission • Advocate for members and families as needed to ensure the member's needs and choices are fully represented and supported by the health care team 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 • Current, unrestricted independent licensure as a Registered Nurse in Colorado • 2+ years of clinical experience • 1+ years of experience with MS Office, including Word, Excel, and Outlook • Driver's License and access to reliable transportation • Ability to travel up to 25% of the time within SW Colorado (Archuleta, La Plata, Dolores, Montezuma) to meet with members and providers • Resdient of Colorado Preferred Qualifications • BSN, master's degree or higher in clinical field • CCM certification • 1+ years of community case management experience coordinating care for individuals with complex needs • Behavioral health experience • Experience working in team-based care • Background in Managed Care 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 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 care coordination for members with medical and behavioral needs through assessments, care planning, and collaboration with providers and community resources. | Requires current clinical licensure, 3+ years clinical experience, 2+ years healthcare experience, MS Office skills, travel capability, and residence in New Mexico. | At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Field Care Coordinator will be the primary care manager for a panel of members with low-to-medium complexity medical/behavioral needs. Care coordination activities will focus on supporting member's medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care. This position is full - time (40 hours / week) Monday - Friday. Employees are required to have flexibility to work any of our 8 - hour shift schedules during our normal business hours of 8am to 5pm. It may be necessary, given the business need, to work occasional overtime. This position is a field - based position with a home - based office. You will work from home when not in the field. If you reside in or within commutable driving distance to Carlsbad, Hobbs or Lovington, New Mexico, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities • Engage members face-to-face and/or telephonically to complete a comprehensive needs assessment, including assessment of medical, behavioral, functional, cultural, and socioeconomic needs • Develop and implement person centered care plans to address needs including management of chronic health conditions, health promotion and wellness, social determinants of health, medication management and member safety in alignment with evidence-based guidelines • Partner and collaborate with internal care team, providers, and community resources/partners to implement care plan • Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health • Support proactive discharge planning and manage/coordinate Care Transition following ER visit, inpatient or Skilled Nursing Facility (SNF) admission • Advocate for members and families as needed to ensure the member's needs and choices are fully represented and supported by the health care team • Create a positive experience and relationship with the member • Practice cultural sensitivity and cultural competence in daily care • Learn and listen to member needs and barriers to help promote self advocating • Collaborating with clinical team of social aspects that might impact treatment plan • Proactively engage the member to manage their own health and healthcare • As needed, help the member engage with mental health and substance use treatment • Provide member education and health literacy on community resources and benefits to encourage self sufficiency • Support member to engage in work or volunteer activities, if desired, and develop stronger social supports through deeper connections with friends, family, and their community • Partner with care team (community, providers, internal staff) • Knowledge and continued learning of community cultures and values • Conduct Comprehensive Needs Assessment (CNA) 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 • Current, unrestricted independent licensure as a Registered Nurse OR a Licensed Clinical Social Worker (LCSW), Licensed Master Social Worker (LMSW), Licensed Professional Clinical Mental Health Counselor, or Licensed Mental Health Counselor (LMHC) OR a LPN with 3+ years of clinical experience • 3+ years of clinical experience • 2+ years of relevant health care experience • 1+ years of experience with MS Office, including Word, Excel, and Outlook • Driver's license and reliable transportation and the ability to travel up to 50% of the time within assigned territory to meet with members and providers • Have a designated workspace inside the home with access to high - speed internet availability • Reside in or within commutable driving distance to Carlsbad, Hobbs or Lovington, NM • Reside in New Mexico Preferred Qualifications • CCM certification • 1+ years of community case management experience coordinating care for individuals with complex needs • Background in Managed Care • Experience working in team-based care • 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. 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.

Provide clinical support and navigation assistance to members including appeals, care coordination, and education while working remotely. | Must have current RN license, 2+ years acute, behavioral health, and Medicaid waiver nursing experience, and ability to work independently with computer skills. | At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Special Needs Senior Clinical Admin Nurse will be responsible for providing individualized attention to UMR membership and covered families and serves to assist with navigation of the health care system. The purpose of the clinical liaison nurse is to help individuals live their lives to the fullest by supporting coordination and collaboration with multiple and external partners including consumers and their families/caregivers, medical, and other clinical teams. Candidate must be willing to work Monday - Friday 8:00 am - 5:00 pm You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities • Provide members with tools and educational support needed to navigate the health care system and manage their health concerns effectively and cost efficiently • Assist members with adverse determinations, including the appeal process • Teach members how to navigate UMR internet-based wellness tools and resources • Outreach to membership providing pre-admission counseling to membership • Outreach to membership providing discharge planning to membership and caretakers • Track all activities and provide complete documentation to generate customer reporting • Accept referrals via designated processes, collaborate in evaluating available services, and coordinate necessary medical care and community referrals as needed • Comply with all policies, procedures and documentation standards in appropriate systems, tracking mechanisms and databases • Contribute to treatment plan discussions • Other 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 • Current and unrestricted RN compact license • Ability to obtain additional licenses as required • 2+ years of acute nursing experience • 2+ years of behavioral health nursing experience • 2+ years of Medicaid waiver experience • Demonstrated basic computer proficiency (i.e. MS Word, Outlook) • Proven ability to function independently and responsibly with minimal supervision Preferred Qualifications • Bachelor's degree in nursing • CCM • 2+ years of managed care experience • 2+ years of case management experience • Critical care, pediatric, med-surg and/or telemetry experience • Utilization management experience • Adverse determination experience • Telecommute experience Soft Skills • Demonstrated excellent verbal and written communication skills • Excellent customer service orientation • Proven team player and team building skills • Ability and flexibility to assume responsibilities and tasks in a constantly changing work 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. 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 manage quality improvement initiatives to enhance care delivery and ensure compliance with health care standards. | At least 5 years of experience in health care quality improvement, strong knowledge of regulations, proficiency in data analysis and quality methodologies, and excellent communication and leadership skills. | Job Title: Quality Improvement Manager - Remote on Oahu, HI Company Overview: UnitedHealthcare is a leading health care company dedicated to simplifying the health care experience and creating healthier communities. We focus on removing barriers to quality care and improving health outcomes for millions of people nationwide. Our innovative approach and commitment to excellence make us a trusted partner in the health care industry. Role Overview: As a Quality Improvement Manager, you will play a critical role in enhancing the quality of care delivered to our members. You will lead initiatives that drive performance improvements, ensure compliance with regulatory standards, and foster a culture of continuous quality enhancement within the organization. What You'll Do: - You will develop and implement quality improvement strategies that align with organizational goals. - You will analyze data to identify trends, gaps, and opportunities for improvement in care delivery. - You will collaborate with cross-functional teams to design and execute quality improvement projects. - You will monitor compliance with health care regulations and accreditation standards. - You will provide training and support to staff on quality improvement methodologies and best practices. - You will prepare reports and presentations to communicate progress and outcomes to leadership. - You will engage with external partners and stakeholders to promote quality initiatives. - You will lead root cause analyses and develop action plans to address quality issues. What You Bring: - Minimum of 5 years of experience in health care quality improvement or related fields. - Strong knowledge of health care regulations, accreditation standards, and quality frameworks. - Proficiency in data analysis tools and quality improvement methodologies such as Lean, Six Sigma, or PDSA. - Excellent communication and leadership skills to influence and drive change. - Ability to manage multiple projects and priorities in a fast-paced environment. Bonus Points If You Have: - Experience working in managed care or health insurance settings. - Certification in quality improvement or project management (e.g., CPHQ, PMP). - Familiarity with electronic health records (EHR) systems and health IT. - Experience leading remote or distributed teams. What We Offer: - We offer a competitive salary and comprehensive benefits package. - We offer flexible remote work options based in Oahu, HI. - We offer opportunities for professional development and career growth. - We offer a supportive and inclusive work environment. - We offer wellness programs and employee assistance resources. Ready to Apply? To apply, please submit your resume and cover letter through our careers portal at UnitedHealthcare.com/careers. We look forward to learning how you can contribute to building the health care system of tomorrow.

Lead clinical practice transformation initiatives by analyzing data, guiding practices to meet quality and efficiency goals, and collaborating with internal and external stakeholders. | 4+ years in clinical quality improvement or transformation, experience with clinical data analytics, strong leadership and communication skills, willingness to travel 25-75%, and remote work capability. | At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Clinical Transformation Manager (CTM) is responsible for the ongoing clinical management of physician practices participating in UnitedHealthcare's (UHC) Accountable Care Organizations (ACO), Value Based Programs, Patient Centered Medical Homes (PCMH), or Population Health Management programs such as Patient Centered Care Model. The CTM will lead multi-disciplined practice transformation and practice performance improvement initiatives. The selected candidate will guide practices in achieving targeted goals that include improved quality, efficiency, and utilization. The CTM is accountable for driving practice progress toward desired transformational change and performance improvement, while meeting savings goals set for the practice. As the single point of clinical contact for a practice, the CTM will be responsible for communicating progress towards achievement of targeted goals to Senior Leadership both within UnitedHealthcare and at the practice. If you are located within the Northeastern region of the U.S, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities • Accountable for successful deployment of UHC's Clinical Support program at the practice level, including but not limited to, introducing, and educating practices on the value/use of reporting tools, patient registries, and delivery of reports via UHC's Physician Portal • Build and effectively maintain relationship with the practice leadership and key clinical influencers actively involved in practice transformation • Regularly facilitate efficient, effective practice improvement meetings with the practice to monitor, present, and discuss progress on the transformation action plan and achievement in milestones • Develop strategies; based on performance analysis, for improvement that includes specific outcomes and metrics to monitor progress to a goal and make recommendations for improvement • Design practice transformation action plans and implement appropriate performance improvement initiatives designed to assist the practice in achieving contractually required transformation milestones • Monitor and review the progress of the practice in milestone achievement and ensure the practice is accountable for successful completion • Use data to analyze key cost, utilization and quality data and interpret results to assess the performance of the practice • Use data to analyze trends and work with stakeholders to agree on and implement proactive strategies to address issues, and measure impact using a PDSA rapid cycle improvement approach, including external practice data • Assist practices in creating workflows to optimize care delivery, introduce best practices improvements, and evaluate outcomes using rapid cycle improvements PDSA methods to reach mutual goals • Educate & Deploy technology tools to support Practice Transformation • Integrate technology tools into practice workflows • Build and effectively maintain relationships with team members in the UHC Clinical organization as well Medical Directors, local Network leads, Health Care Economic Analysts and Clinical Analysts in support of the program • Consult and partners with internal UHC matrix partners and the practice to identify organizational and structural challenges hindering achievement of desired program outcomes • Collaborate with UnitedHealthcare teams including the practice Care Coordinators, quality management teams, hospital clinical teams, behavioral health teams to support integrated PCP driven care for our members with practices and hospitals • Consult and guide the practice on developing innovative solutions, including bringing best practice experience and connecting practices with other high performing practices to spur innovation • Work with the practice and Optum to align and integrate Optum care/disease management programs and population health services to augment the practice's capabilities, support their care management efforts and add value to the patient care experience • Assist and support department leaders in summarizing and disseminating experience - related learnings by way of team updates, written reports / articles, and / or presentations as called for by directors 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 combined experience with improving clinical quality, health care analytics, or driving clinical transformation initiatives with population health programs, Patient Center Medical Homes or in Accountable Care Organizations • Experience in interpreting and utilizing clinical data analytics, outcomes measurement in healthcare and use of that data to drive change • Experience working with and collaborating successfully with senior level leadership • Demonstrated experience leading groups and solid presentation skills • Solid Microsoft Office Skills with Word, Excel, Outlook, and PowerPoint • Proven solid relationship building skills with internal and practice teams to drive goal alignment • Access to high-speed internet for home office set up • Willingness to travel between 25-75% for face-to-face meetings (varies by market) • Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area (markets may require valid driver's license) Preferred Qualifications • Demonstrated experience implementing Clinical Practice Transformation initiatives designed to help provider or hospital groups achieve large-scale health transformation goals • Experience preparing and presenting information to clinical and executive level leadership • Physician practice experience • 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.

Manage vendor relationships and operational processes for Financial Protection line of business, lead projects, support technology integrations, and provide executive updates. | Proven project management, vendor relationship expertise, knowledge of benefit administration vendors, communication skills, and experience with EDI/API data exchange. | At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The Eligibility and Enrollment Vendor Relationship Manager provides management of vendor programs and relationships, impacting operational/administrative capabilities (including APIs and other capabilities) for Small Group, Key Account, National Account and Public Sector clients and brokers in the Financial Protection line of business. This role acts as a service liaison between Financial Protection Operations, Strategic Benefit Admin vendors, and the Financial Protection Market and Product teams for the purpose of improving the operational experience between UHC and our Benefit Admin partners. Critical components of this position are developing and enhancing working relationships with Benefit Admin partners and promoting technical and process advancements that keep us competitive in the market. This Relationship Manager also has accountability for providing monthly and quarterly executive business updates and plans across their scope. Managing partner relations also includes legacy operational experience (such as EDI), alignment to standards, escalation support, and overall operational readiness particularly within the enrollment process. You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: • Responsible for providing operational, business process direction and improvement ideas across all segments of Financial Protection • Maintain ongoing global vendor / partner relationships with prioritized partners. Create long term interactive relationships with each partner’s operational leadership (as well as internal functional matrix partnerships) • Represent Financial Protection Operations and platforms, support program and relationship strategic oversight for all markets and lines of business • Support Sales/Health Plan engagement and other internal market and product partners • Conduct root cause and trend analysis to understand vendor performance • Develop and support program metrics • Educate, promote adherence to all processing standards • Promote progress toward modern technological capabilities for UHC Financial Protection in partnership with vendors • Identify and support book of business growth opportunities • Communicate platform and technology changes, or other strategic changes to vendors / brokers • Coordinate and communicate best practices across all capabilities (including API, EDI and other) • Annually, conduct surveys, discovery sessions, or send questionnaires to vendors / brokers capture feedback • Maintain documented nuances / profiles for understanding key partners • Communicate partner trends or process changes to leadership • Act as a Subject Matter Expert: support inquiries from internal FP partners such as: Requests for Proposal; Marketing; Digital Modernization; Sales; Implementation; Client Services, etc. • Support escalations, triage, assist with issue resolution • Manage Vendor / Partner issue intake – research and work with appropriate internal partners to identify a solution • Provide general project management services, document project logs, lead workstreams, align stakeholders, timelines, drive integrations, etc. • Negotiate favorable outcomes for both external and internal parties • Deliver presentations to venders, clients, or brokers in support of UHC vendor capabilities • Conduct external vendor meetings to ensure partnerships, gain market knowledge and insight, and address any issues identified internally or externally as it pertains to vendor interactions with FP Ops • Travel may be required to develop and maintain vendor relationships Additional responsibilities include: • Complete project work as assigned accurately and within specified deadlines • Participate in relevant training opportunities that will enhance market partnerships • Other projects and tasks as delegated by leadership 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: • Solid proven project management experience, managing multiple projects concurrently • Proven expertise building relationships and delivering exceptional results for customers • Experience successfully influencing without direct authority over stakeholders • Demonstrated knowledge of benefit administration vendor ecosystem (i.e. payroll and benefit enrollment vendors) • Excellent written and verbal communication skills, competent in presentation of materials • Proficiency in Microsoft Word, Excel, and PowerPoint • Experience with EDI or API data exchange methodology; experience mapping data files and resolving errors Preferred Qualifications: • Enrollment / Eligibility understanding • Knowledge of UHC’s internal delivery system (eligibility, case install, billing, implementation, U/W, etc.) • Understanding of or experience with LDEX and Employee Navigator data formats and processes • Experience working with technology teams on defining requirements • Data analysis and reporting experience • 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 re 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 $89,800 to $160,600 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.

Analyze healthcare claims and financial data to identify cost-saving opportunities and support pricing strategies while presenting findings to stakeholders. | Intermediate proficiency in Excel, data analytics, SAS/SQL, excellent communication and problem-solving skills, plus 2+ years healthcare analytics or related experience. | At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. Why work for the leading organization in health care to help improve the lives of millions? You'll find that this is no small opportunity on our Health Care Economics team. There are new challenges and bigger rewards around every turn. Now is the time, and this the place where you'll find a career in which you can make a big difference in our company, our industry, even our world. As the Senior Network Pricing Analyst, you will design and develop reports and analyze data to measure clinical outcomes, network performance and methodology levers. You will investigate key business problems through quantitative analyses of utilization and health care costs data. Along with your team, you will identify potential areas for medical cost improvements and alternative pricing strategies. You will help heal the health care system as you work with an elite team to solve tough challenges. Join us This position follows a hybrid schedule with three in-office days per week in Las Vegas, NV. Primary Responsibilities: • Deliver actionable data insights by analyzing claims, capitation, and membership data to support financial, actuarial, and utilization management functions • Present financial impact findings to cross-functional stakeholders in a clear and concise manner • Drive cost-efficiency by identifying opportunities for medical cost savings and recommending innovative pricing strategies • Monitor and report on the financial impact of proposed and executed contracts in relation to budgets, market goals, and strategic business plans • Leverage reimbursement expertise by applying a strong understanding of commercial and Medicaid reimbursement policies to support pricing and contracting decisions • Support tool development by contributing to the design and enhancement of contract modeling tools and analytical products that improve pricing accuracy and decision-making You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • Intermediate level of proficiency working with MS Excel including formulas, calculations, charts, graphs, etc. • Intermediate level of proficiency in performing data analytics • Intermediate level proficiency with SAS/SQL • Proven excellent organizational, problem-solving, and communication skills Preferred Qualifications: • 2+ years of experience in healthcare analytics, financial, or related field • 2+ years of experience working with relational databases • Experience supporting contract modeling, financial forecasting, or cost containment initiatives • Ability to quickly learn and use computer software tools effectively 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.

Promote health care sales telephonically with General Agent partners, build and maintain relationships with agents and brokers, assist with sales proposals and escalated service issues, and meet health plan sales goals. | Requires a State Life and Health Insurance License or ability to obtain, 2+ years sales or customer service experience preferably in health insurance, ability to work independently, and a driver's license with reliable transportation. | At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. The primary duty of the General Agent Account Executive is to promote health care sales and market UHC products telephonically, with our General Agent partners. The General Agent Account Executive is part of the California Small Business Sales Department and focuses on the small business market segment, those customers employing up to 99 employees. This position follows a hybrid schedule with Three in-office days per week. Primary Responsibilities: • Identifies potential health care business customers through prospecting and outbound calls • Develop business relationships over the phone, with agents and/or brokers to increase sales • Promotes sales of health care products through brokers including: • Educating and keeping General Agent partners up to date on UHC products and pricing • Evaluating and discussing with General Agent partners how UHC products meet the needs of the brokers' customers • Assisting General Agents in developing sales proposals, including anticipating competing products and distinguishing UHC's products from those competing products • Attaining health plan goals related to specific targeted health care products • Assisting with general agents with escalated service issues • Assisting general agents with new business submissions • Produces agent/broker sales that result in profitable premium levels for the company • Product Knowledge: • Solid knowledge of all products sold in their market segment, including competitive products; applies independent judgment to recommend products for a given customer's situation • Very solid organizational skills are key to balancing multiple priorities, objectives, and customer obligations • Time management skills are critical to success • Relationship Building and Influence: • Build solid relationships with General Agent partners and brokers through frequent phone and virtual visit contact • Maintains solid relationships with existing agents and brokers to promote and sustain sales You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: • State Life and Health Insurance License or ability to obtain upon hire • 2+ years of sales, service, and/or customer service experience preferably within the health insurance industry • Demonstrated ability to work independently to establish and grow relationships with general agents • Driver's License and access to a reliable transportation Preferred Qualifications: • Knowledge and understanding of underwriting, financial and analytical details as necessary 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.

Assess, plan, and implement individualized care strategies, manage care plans, coordinate with stakeholders, and advocate for patients in community health settings. | Current unrestricted RN license in TX, 2+ years community health or healthcare experience, valid driver's license with travel ability, Microsoft Office proficiency, and residence within 50 miles of McLennan County, TX. | At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. If you are located within 50 miles of McLennan, TX or surrounding areas, you will have the flexibility to work remotely* as you take on some tough challenges. This is a Field Based role with a Home-Based office. Primary Responsibilities • Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, at least restrictive level of care • Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services • Manage the care plan throughout the continuum of care as a single point of contact Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members • Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team 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 • Current unrestricted RN license in the state of TX • 2+ years of experience working within the community health setting or in a health care role • Familiarity with Microsoft Office, including Word, Excel, and Outlook • A valid driver's license, reliable transportation and the ability to travel up to 75% within McLennan County, TX designated territory to visit Medicaid members in their homes and/or other settings, including community centers, hospitals, nursing facilities or providers' offices • High-speed internet at residence • Reside within 50 miles from McClennan County, TX Preferred Qualifications • 1+ years of experience with long term care services and support, Medicaid or Medicare • Knowledge of the principles of most integrated settings, including federal and State requirements like the federal home and community-based settings regulations. • Demonstrated ability to create, edit, save and send documents, spreadsheets and emails • Reside within commutable distance of assigned duties • 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.